3. Challenges in management of NTM infection
Surgical debridement was the mainstay of treatment for bone and soft
tissue infection (17) with prolonged anti-mycobacterial treatment in
terms of at least 6 to 12 months (17-19). Drug-related toxicities and
development of drug resistance may be encountered. As in our patient,
antibiotics had to be stopped in view of drug-related rash and liver
toxicity. Experience on use of bedaquiline and clofazimine as salvage
therapy was limited without efficacy and safety profile for paediatric
population documented in literature (20). Meticulous counselling of
patient and parents before usage and close monitoring of potential side
effects and drug interactions were crucial.