Prescribing Patterns for Treatment of Mycobacterium avium Complex and M. xenopi Pulmonary Disease in Ontario, Canada, 2001–2013
| Autor: | 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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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Emerging Infectious Diseases, Vol 25, Iss 7, Pp 1271-1280 (2019) |
| Druh dokumentu: | article |
| ISSN: | 1080-6040 1080-6059 |
| DOI: | 10.3201/eid2507.181817 |
| Popis: | 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. |
| Databáze: | Directory of Open Access Journals |
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