TABLE 2.

Recommendations on treatments of NTM skin infections.

	Recommendations
1. The characteristics required for novel anti-NTM drugs	1). Are ideally active against a broader spectrum of NTM; 2). Are bactericidal ideally against growing, and various drug-tolerant persist pathogens; 3). Could penetrate the multilayered structure of granulomas; 4). Drug interactions should be as minimal as possible
2. Choose the right treatment choices for each patient	After careful interpretation of the drug sensitivity results and the characteristics of the different cases, the choice of using a single therapy, a combination of antibiotics, physical therapy, or multiple parallel approaches is made
3. Drug monitoring and sensitivity tests are necessary	Therapeutic drug monitoring and prolonged drug sensitivity tests are always necessary during treatment. Clinical and laboratory monitoring of patients is essential. Treatment should be also tailored to the NTM species and susceptibility profile
4. Develop/screen drugs with the help of new platforms and new ideas	Referring to formal pharmacokinetics/pharmacodynamics research (such as CRISPR/Cas9 system and nanotechnology) might lead to safer and shorter-duration regimens. Novel molecular diagnostic technology can offer more effective, targeted multidrug treatments at the species level
5. Prevention and skin care are essential	Prevention is equally essential during percutaneous invasive operations or trauma. Immunosuppressed hosts need to pay more attention to infection during antimicrobial therapy. Proper wound care is also an important aspect of NTM skin disease management
6. Patient education and condition explanation	Counseling patients about the characteristics of NTM infections, such as choices of treatment, length of treatment, and possible side effects, to moderate their expectations for an unrealistic solution. Patients should also be advised to promptly report any new symptoms or changes in the affected skin to their healthcare provider
7. Multidisciplinary Cooperation	Multidisciplinary approach involving dermatologists, infectious disease specialists, and surgeons are recommended. Collaboration among healthcare professionals is important in determining the appropriate treatment plan, monitoring treatment response, and addressing potential complications