TY - JOUR
T1 - Prescribing patterns for treatment of mycobacterium avium complex and m. Xenopi pulmonary disease in ontario, canada, 2001–2013
AU - Brode, Sarah K.
AU - Chung, Hannah
AU - Campitelli, Michael A.
AU - Kwong, Jeffrey C.
AU - Marchand-Austin, Alex
AU - Winthrop, Kevin L.
AU - Jamieson, Frances B.
AU - Marras, Theodore K.
N1 - Publisher Copyright:
© 2019, Centers for Disease Control and Prevention (CDC). All rights reserved.
PY - 2019/7
Y1 - 2019/7
N2 - Surveys suggest that clinicians diverge from guidelines when treating Mycobacterium avium complex (MAC) pulmonary disease (PD). To determine prescribing patterns, we conducted a cohort study of adults >66 years of age in Ontario, Canada, with MAC or Mycobacterium xenopi PD during 2001–2013. Using linked laboratory and health administrative databases, we studied the first treatment episode (>60 continuous days of >1 of a macrolide, ethambutol, rifamycin, fluoroquinolone, linezolid, inhaled amikacin, or, for M. xenopi, isoniazid). Treatment was prescribed for 24% MAC and 15% of M. xenopi PD patients. Most commonly prescribed was the recommended combination of macrolide, ethambutol, and rifamycin, for 47% of MAC and 36% of M. xenopi PD patients. Among MAC PD patients, 20% received macrolide monotherapy and 33% received regimens associated with emergent macrolide resistance. Although the most commonly prescribed regimen was guidelines-recommended, many regimens prescribed for MAC PD were associated with emergent macrolide resistance.
AB - Surveys suggest that clinicians diverge from guidelines when treating Mycobacterium avium complex (MAC) pulmonary disease (PD). To determine prescribing patterns, we conducted a cohort study of adults >66 years of age in Ontario, Canada, with MAC or Mycobacterium xenopi PD during 2001–2013. Using linked laboratory and health administrative databases, we studied the first treatment episode (>60 continuous days of >1 of a macrolide, ethambutol, rifamycin, fluoroquinolone, linezolid, inhaled amikacin, or, for M. xenopi, isoniazid). Treatment was prescribed for 24% MAC and 15% of M. xenopi PD patients. Most commonly prescribed was the recommended combination of macrolide, ethambutol, and rifamycin, for 47% of MAC and 36% of M. xenopi PD patients. Among MAC PD patients, 20% received macrolide monotherapy and 33% received regimens associated with emergent macrolide resistance. Although the most commonly prescribed regimen was guidelines-recommended, many regimens prescribed for MAC PD were associated with emergent macrolide resistance.
UR - http://www.scopus.com/inward/record.url?scp=85068475489&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068475489&partnerID=8YFLogxK
U2 - 10.3201/eid2507.181817
DO - 10.3201/eid2507.181817
M3 - Article
C2 - 31215507
AN - SCOPUS:85068475489
SN - 1080-6040
VL - 25
SP - 1271
EP - 1280
JO - Emerging infectious diseases
JF - Emerging infectious diseases
IS - 7
ER -