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 - Funding Information:
We thank IMS Brogan Inc. for use of their Drug Information Database.
Funding Information:
This study was supported by ICES and Public Health Ontario, which are funded by annual grants from the Ontario Ministry of Health and Long-Term Care. The opinions, results, and conclusions reported in this article are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario Ministry of Health and Long-Term Care is intended or should be inferred. Parts of this material are based on data and/or information compiled and provided by the Canadian Institute of Health Information. However, the analyses, conclusions, opinions, and statements expressed herein are those of the authors, and not necessarily those of the Institute.
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.
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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 -