Therapeutic Management Strategies Among Immunocompetent Infants with Nontuberculous Mycobacterial Pulmonary Infection
Abstract
Purpose: The prevalence of pulmonary nontuberculous mycobacteria (NTM) infection and disease is increasing globally. Pediatric studies on treatment of pulmonary NTM disease in immunocompetent infants are limited, and adult guidelines lack details regarding age-specific management strategies. This systematic review analyzes pharmaceutical, procedural, and supportive management strategies for pulmonary NTM infections in immunocompetent infants based on published case reports and series.
Methods: A systematic review of PubMed for case reports on pulmonary NTM infections in immunocompetent infants (≤24 months) until December 2023 was conducted. Demographic information, therapeutic interventions, procedural details, and patient outcomes were extracted to Covidence. Data on therapeutic strategies were summarized descriptively.
Results: Twenty-six case reports describing 33 infants with pulmonary NTM were identified. Study demographics included: 55% female, median age at diagnosis was 12 months, and Mycobacterium avium complex (58%) was the most common NTM strain. Most patients (94%) received antibiotic therapy, with a median treatment duration of 30 weeks. Common regimens included combined ethambutol with rifampin (n=9) or clarithromycin (n=6), and clarithromycin with amikacin (n=6). Most patients started on therapy for tuberculosis before switching treatment courses after NTM diagnosis. Common antibiotic classes after NTM diagnosis were macrolides, antituberculous, and…
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