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 Winthrop, Frances B. Jamieson, Theodore K. Marras

Research output: Contribution to journalArticle

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)
JournalEmerging infectious diseases
Volume25
Issue number7
DOIs
StatePublished - Jul 1 2019

Fingerprint

Mycobacterium avium Complex
Mycobacterium xenopi
Ontario
Macrolides
Lung Diseases
Canada
Ethambutol
Linezolid
Therapeutics
Guidelines
Amikacin
Fluoroquinolones
Isoniazid
Cohort Studies
Databases
Health

Keywords

  • Canada
  • Mycobacterium avium complex
  • Mycobacterium infections
  • Mycobacterium xenopi
  • nontuberculous
  • Nontuberculous mycobacteria
  • Ontario
  • respiratory infections
  • treatment
  • tuberculosis and other mycobacteria

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Prescribing Patterns for Treatment of Mycobacterium avium Complex and M. xenopi Pulmonary Disease in Ontario, Canada, 2001-2013. / Brode, Sarah K.; Chung, Hannah; Campitelli, Michael A.; Kwong, Jeffrey C.; Marchand-Austin, Alex; Winthrop, Kevin; Jamieson, Frances B.; Marras, Theodore K.

In: Emerging infectious diseases, Vol. 25, No. 7, 01.07.2019.

Research output: Contribution to journalArticle

Brode, Sarah K. ; Chung, Hannah ; Campitelli, Michael A. ; Kwong, Jeffrey C. ; Marchand-Austin, Alex ; Winthrop, Kevin ; Jamieson, Frances B. ; Marras, Theodore K. / Prescribing Patterns for Treatment of Mycobacterium avium Complex and M. xenopi Pulmonary Disease in Ontario, Canada, 2001-2013. In: Emerging infectious diseases. 2019 ; Vol. 25, No. 7.
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