Table 1.
Classification of NTM species and pharmacotherapeutics with in vitro microbiologic activity [8, 12, 15–19]
| Classification and major groups | Pharmacotherapeutics | |
|---|---|---|
| Preferred agentsa | Alternative agents | |
| Slow-growing NTM (colonization > 7 days) | ||
| M. avium complexb | AMK, AZM, EMB, RFB, RIF | BDQ, CLO, CLR, CZA, ETO, LZD, MXF, SXT, TGC, TZD |
| M. kansasii | AZM, CIP, EMB, INH, LVX, MXF, RFB, RIF | AMK, BDQ, CLO, CLR, LZD, SXT, TGC, TZD |
| M. marinum | AZM, EMB, RFB, RIF | AMK, CIP, CLR, DOX, INH, IPM, LVX, LZD, MIN, MXF, SXT, TZD |
| M. scrofulaceum | AZM, CIP, CLR, LVX, MXF | EMB, LZD, MIN, RFB, RIF |
| M. haemophilum | AZM, CIP, CLR, RFB, RIF | AMK, CLO, DOX, SXT |
| M. terrae complexc | AZM, CLR, EMB, RIF | AMK, CIP, ETO, LVX, LZD, MXF, SXT |
| M. xenopi | AZM, CLR, EMB, RFB, RIF | AMK, INH, LVX, MXF |
| M. ulcerans | AMK, AZM, EMB, RFB, RIF | CLR, MXF, SXT, TET |
| M. malmoense | AZM, EMB, LVX, MXF, RFB, RIF | CLR, INH |
| M. celatum | AZM, EMB, LVX, MXF, RFB | AMK, CLR, INH, PZA |
| M. genavense | AZM, RFB, RIF | AMK, CLO, CLR, EMB, LVX, MXF |
| M. simiae complexd | CLR, EMB, MXF, RFB, RIF, SXT | AMK, CLO, LZD |
| M. szulgai | AZM, EMB, RIF | AMK, CLR, INH, LVX, MXF, PZA |
| M. gordonae | AZM, CLR, EMB, RIF | INH, LVX, LZD, MXF, RFB, SXT |
| Rapid-growing NTM (colonization ≤ 7 days) | ||
| M. fortuitum complexe | AMK, CIP, DOX, IPM, LVX, MIN, MXF, SXT | FOX, LZD, OMC, TGC, TOB |
| M. chelonae | AZM, IPM, LZD, TOB | CIP, CLO, CLR, DOX, LVX, MIN, MXF, OMC, SXT, TGC |
| M. abscessus complexf | AMK, AZM, FOX, IPM | BDQ, CIP, CLO, CLR, ERV, IMR, LVX, LZD, MXF, OMC, TGC, TZD |
| M. smegmatis groupg | AMK, CIP, DOX, MXF, SXT | AZM, CLO, CLR, EMB, FOX, IPM |
| M. immunogenum | AMK, AZM, TGC | CLR, IPM, LZD, TZD |
| M. mucogenicum | AMK, AZM, CIP, FOX, IPM, LVX, MXF, SXT | AMX, CLR, DOX, LZD, MIN |
AMK amikacin, AMX amoxicillin, AZM azithromycin, BDQ bedaquiline, CIP ciprofloxacin, CLO clofazimine, CLR clarithromycin, CZA ceftazidime/avibactam, DOX doxycycline, EMB ethambutol, ERV eravacycline, ETO ethionamide, FOX cefoxitin, IMR imipenem/relebactam, INH isoniazid, IPM imipenem, LVX levofloxacin, LZD linezolid, MIN minocycline, MXF moxifloxacin, NTM nontuberculous mycobacterial, OMC omadacycline, PZA pyrazinamide, RFB rifabutin, RIF rifampin, SXT sulfamethoxazole/trimethoprim, TET tetracycline, TGC tigecycline, TOB tobramycin, TZD tedizolid
aComplete regimen is typically composed of 2–4 agents according to infection site and disease severity. Drug selection is based on clinical evidence for effectiveness, safety, ease of administration, and medication tolerability
bM. avium complex comprises M. avium, M. intracellulare, and M. subsp. chimaera
cM. terrae complex comprises M. terrae, M. triviale, M. nonchromogenicum, and M. hiberniae
dM. simiae complex comprises M. simiae, M. sherisii, M. lentiflavum, M. triplex, M. heidelbergense, and M. simiae subsp. palustre
eM. fortuitum complex comprises M. fortuitum, M. neworleansense, M. peregrinum, M. boenickei, M. alvei, M. porcinum, M. conceptionense, M. farcinogenes, M. senegalense, and M. mageritense
fM. abscessus complex comprises M. abscessus subsp. abscessus (sensu stricto), M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii
gM. smegmatis group comprises M. smegmatis, M. wolinskyi, and M. goodii