Clinical considerations of the safety and efficacy of clofazimine in the treatment of nontuberculous mycobacterial disease.

Clofazimine (CFZ) has been shown to exhibit synergism with amikacin and clarithromycin against nontuberculous mycobacteria (NTM), and is thus being repositioned to treat associated infections. However, clinical evidence supporting its efficacy and optimal dosage remains limited. Nonetheless, in vitro and retrospective studies have suggested its potential utility in treating NTM pulmonary disease. Moreover, CFZ pharmacokinetics and CFZ-induced side effects, such as pigmentation, heart rate corrected QT interval prolongation, and gastrointestinal disorders, are well characterized. This study aims to outline the pharmacokinetics of CFZ, as well as its efficacy and side effects, to inform its optimal use in the treatment of NTM pulmonary disease.