Contemporary Pharmacotherapies for Nontuberculosis Mycobacterial Infections: A Narrative Review

Johnson, Trevor; Byrd, Thomas F.; Drummond, Wendi K.; Childs‐Kean, Lindsey M.; Mahoney, Monica V; Pearson, Jeffrey C; Rivera, Christina G.

doi:10.1007/s40121-022-00750-5

Cited by 4 publications

(1 citation statement)

References 104 publications

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“…A dual combination of macrolides/azalides, fluoroquinolones and rifampicin may also be effective in non‐complicated cases of cutaneous and soft tissue NTM infections. This combination is similar to the treatment protocol used for tuberculous mycobacteria (Johnson et al., 2023). Additional doxycycline monohydrate and/or clofazimine administration can also be useful (O'Halloran & Dobromylskyj, 2017b).…”

Section: Discussionmentioning

confidence: 99%

Cutaneous mycobacteriosis caused by Mycobacterium avium subspecies avium in a dog: Clinical findings, histopathological and molecular diagnosis and treatment

Golchin,

Sasani,

Asadian

et al. 2024

Veterinary Medicine & Sci

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A 3‐year‐old castrated male Jack Russell Terrier with a history of cholestatic hepatitis was presented with a non‐painful and non‐pruritic, subcutaneous nodule following vaccine injection. The dog was otherwise healthy. The nodule was surgically removed. Upon gross inspection, a firm, glistening and loculated tissue was seen within the panniculus. Histopathologically, extensive pyogranulomatous panniculitis was diagnosed, composed of variably sized lipocyst surrounded by neutrophils and an outer zone of foamy epithelioid macrophages, neutrophils and occasional Langhans form giant cells. Although histopathologic findings were most compatible with mycobacteriosis, other infectious and sterile conditions were considered differential diagnoses. Gram, acid‐fast and periodic acid Schiff staining were negative. However, PCR analyses for mycobacterial rpoB gene and sequencing revealed infection with Mycobacterium avium subsp. avium. Empirical treatment was avoided through the 3‐week course of histopathological and molecular investigations. Considering that there were no newly formed cutaneous masses, marbofloxacin (2 mg/kg, PO q24h) was administered for 2 weeks, and clarithromycin was avoided due to its potential cholestatic hepatitis adverse effects. Eight months following surgery, there are no new or relapsing cutaneous lesions or disease‐specific complications. This suggests that marbofloxacin monotherapy may be sufficient in immunocompetent dogs with early detection of localized cutaneous mycobacteriosis lacking lymph node or organ involvement.

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Section: Discussionmentioning

confidence: 99%

Cutaneous mycobacteriosis caused by Mycobacterium avium subspecies avium in a dog: Clinical findings, histopathological and molecular diagnosis and treatment

Golchin,

Sasani,

Asadian

et al. 2024

Veterinary Medicine & Sci

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Nα‐Aroyl‐N‐Aryl‐Phenylalanine Amides: A Promising Class of Antimycobacterial Agents Targeting the RNA Polymerase

Seidel,

Goddard,

Lang

et al. 2024

Chemistry & Biodiversity

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Tuberculosis (TB), mainly caused by Mycobacterium tuberculosis, remains the leading cause of death from a bacterium in the world. The global prevalence of clinically relevant infections with opportunistically pathogenic non‐tuberculous mycobacteria (NTM) have also been on the rise. Pharmacological treatment of both TB and NTM infections usually requires prolonged regimens of drug combinations, and is often challenging because of developed or inherent resistance to common antibiotic drugs. Medicinal chemistry efforts are thus needed to improve treatment options and therapeutic outcomes. Nα‐aroyl‐N‐aryl‐phenylalanine amides (AAPs) have been identified as potent antimycobacterial agents that target the RNA polymerase with a low probability of cross resistance to rifamycins, the clinically most important class of antibiotics known to inhibit the bacterial RNA polymerase. In this review, we describe recent developments in the field of AAPs, including synthesis, structural characterization, in vitro microbiological profiling, structure‐activity relationships, physicochemical properties, pharmacokinetics and early cytotoxicity assessment.

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Pharmacotherapeutic Considerations in the Treatment of Nontuberculous Mycobacterial Infections: A Primer for Clinicians

Cimino,

Rivera,

Pearson

et al. 2024

Open Forum Infectious Diseases

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Non-tuberculous mycobacteria (NTM) can cause a variety of infections, including serious pulmonary disease. Treatment encompasses polypharmacy, with a targeted regimen of 2-5 active medications, depending on site of infection, species, and clinical characteristics. Medications may include oral, intravenous, and inhalational routes. Medication acquisition can be challenging for numerous reasons, including investigational status, limited distribution models, and insurance prior authorization. Additionally, monitoring and managing adverse reactions and drug interactions is a unique skill set. While NTM is primarily medically managed, clinicians may not be familiar with the intricacies of medication selection, procurement, and monitoring. This review offers insights into the pharmacotherapeutic considerations of this highly complex disease state, including regimen design, medication acquisition, safety monitoring, relevant drug-drug interactions, and adverse drug reactions.

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Contemporary Pharmacotherapies for Nontuberculosis Mycobacterial Infections: A Narrative Review

Cited by 4 publications

References 104 publications

Cutaneous mycobacteriosis caused by Mycobacterium avium subspecies avium in a dog: Clinical findings, histopathological and molecular diagnosis and treatment

Cutaneous mycobacteriosis caused by Mycobacterium avium subspecies avium in a dog: Clinical findings, histopathological and molecular diagnosis and treatment

Nα‐Aroyl‐N‐Aryl‐Phenylalanine Amides: A Promising Class of Antimycobacterial Agents Targeting the RNA Polymerase

Pharmacotherapeutic Considerations in the Treatment of Nontuberculous Mycobacterial Infections: A Primer for Clinicians

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