Table 2.

Advantages and disadvantages of alternative therapies against M. abscessus.

Therapeutic Strategy	Advantages	Disadvantages
Antibiofilm	Compounds of very diverse chemical nature. Improves sensitivity to different antimicrobials. Reduces the persistence of M. abscessus in the human organism.	They do not have antimicrobial action by themselves.
Nanoparticles	Allow a greater and better distribution and bioavailability of antimicrobials. Reduce toxicity of drugs with respect to their free form. Reduce side effects.	Scaling and quality control is challenging.
Vaccines	Stimulate immune status against M. abscessus. Reduce the severity of infections.	In general, there is a greater response against smooth strains than against rough strains. It is a non-curative and only a preventive alternative. Still needs to be properly validated.
Antimicrobial peptides	Very diverse origin, both natural and chemical synthesis. Easy to obtain and to test against M. abscessus. Show antimicrobial activity both on their own and in combination.	May be toxic to human cells. Not degraded in human serum.
Host Modulation Therapy	Regulation of local immune response. Direct or indirect antibacterial activity (secreting NO, antimicrobial peptides, autophagy). Repairing tissue damage. Accumulation at site of infection.	Potential side effects. Different biological functions of MSCs in different tissue sources and in vitro culture conditions. Treatment selected according to individual immune status. Different lifestyles of Mycobacteria′s host cells.
Photodynamic therapy	High antibacterial effectiveness. Broad antimicrobial spectrum. Low host damage and fewer side effects. No resistance induction to the therapy. Short treatment time. Little invasiveness.	Treatment effectiveness depends on suitable PS and light. Photosensitivity after treatment.
Phage therapy	Single phage treatment is possible. Specificity of action. Treatment of chronic and recurrent infections with no other clinical outcome. Easy administration. Can be improved by engineering.	Possible emergence of bacterial resistance. High costs for formulation and stabilization of pharmaceutical preparations. Neutralizing antibodies. Very few clinical trials.