Bedaquiline as Treatment for Disseminated Nontuberculous Mycobacteria Infection in 2 Patients Co-Infected With HIV

Eliza Gil; Nicola Sweeney; Veronica Barrett; Stephen Morris-Jones; Robert F. Miller; Victoria J. Johnston; Michael Brown

Disclosures

Emerging Infectious Diseases. 2021;27(3):944-948. 

In This Article

Abstract and Introduction

Abstract

Nontuberculous mycobacteria can cause disseminated infections in immunocompromised patients and are challenging to treat because of antimicrobial resistance and adverse effects of prolonged multidrug treatment. We report successful treatment with bedaquiline, a novel antimycobacterial drug, as part of combination therapy for 2 patients with disseminated nontuberculous mycobacteria co-infected with HIV.

Introduction

Nontuberculous mycobacteria (NTM) cause a broad spectrum of disease, most commonly pulmonary infection, but also cause disseminated infection in immunocompromised patients, posing a major risk for illness and death.[1] Treatment involves immune function optimization and prolonged use of combinations of species-specific antimycobacterial drugs but is often complicated by the intrinsic or acquired drug resistance of NTM[2] and adverse effects of the drug combinations; treatment failure is common. Therefore, there is considerable interest in the use of novel drugs.[3]

Bedaquiline, a novel, oral, diarylquinolone antimycobacterial drug, is used in treatment of infections with multidrug-resistant Mycobacterium tuberculosis.[4] However, its role in treatment of disseminated NTM infections remains unclear. We report the successful use of bedaquiline in treatment for 2 HIV-infected patients in London, UK, who had disseminated NTM infections.

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