Alternative and Experimental Therapies of <i>Mycobacterium abscessus</i> Infections

oleh: Michal Meir, Daniel Barkan

Format: Article
Diterbitkan: MDPI AG 2020-09-01

Deskripsi

<i>Mycobacterium abscessus</i> is a non-tuberculous mycobacterium notoriously known for causing severe, chronic infections. Treatment of these infections is challenging due to either intrinsic or acquired resistance of <i>M. abscessus</i> to multiple antibiotics. Despite prolonged poly-antimicrobial therapy, treatment of <i>M. abscessus</i> infections often fails, leading to progressive morbidity and eventual mortality. Great research efforts are invested in finding new therapeutic options for <i>M. abscessus.</i> Clofazimine and rifabutin are known anti-mycobacterial antibiotics, repurposed for use against <i>M. abscessus</i>. Novel antimicrobials active against <i>M. abscessus</i> include delamanid, pretomanid and PIPD1 and the recently approved beta-lactamase inhibitors avibactam, relebactam and vaborbactam. Previously unused antimicrobial combinations, e.g. vancomycin–clarithromycin and dual beta-lactam therapy, have been shown to have synergistic effect against <i>M. abscessus</i> in experimental models, suggesting their possible use in multiple-drug regimens. Finally, engineered phage therapy has been reported to be clinically successful in a severe case of disseminated <i>M. abscessus</i> infection. While many of these experimental therapeutics have shown activity against <i>M. abscessus</i> in vitro, as well as in intracellular and/or animal models, most have little if any evidence of effect in human infections. Clinical studies of <i>M. abscesssus</i> treatments are needed to reliably determine the value of their incorporation in therapeutic regimens.