Prescribing patterns for treatment of mycobacterium avium complex and m. Xenopi pulmonary disease in ontario, canada, 2001–2013

Sarah K. Brode, Hannah Chung, Michael A. Campitelli, Jeffrey C. Kwong, Alex Marchand-Austin, Kevin L. Winthrop, Frances B. Jamieson, Theodore K. Marras

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)1271-1280
Number of pages10
JournalEmerging infectious diseases
Volume25
Issue number7
DOIs
StatePublished - Jul 2019

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ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Brode, S. K., Chung, H., Campitelli, M. A., Kwong, J. C., Marchand-Austin, A., Winthrop, K. L., Jamieson, F. B., & Marras, T. K. (2019). Prescribing patterns for treatment of mycobacterium avium complex and m. Xenopi pulmonary disease in ontario, canada, 2001–2013. Emerging infectious diseases, 25(7), 1271-1280. https://doi.org/10.3201/eid2507.181817