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Volume 25, Number 7—July 2019

Prescribing Patterns for Treatment of Mycobacterium avium Complex and M. xenopi Pulmonary Disease in Ontario, Canada, 2001–2013

Sarah K. BrodeComments to Author , Hannah Chung, Michael A. Campitelli, Jeffrey C. Kwong, Alex Marchand-Austin, Kevin L. Winthrop, Frances B. Jamieson, and Theodore K. Marras
Author affiliations: West Park Healthcare Centre, Toronto, Ontario, Canada (S.K. Brode); ICES, Toronto (S.K. Brode, H. Chung, M.A. Campitelli, J.C. Kwong); University of Toronto, Toronto (S.K. Brode, J.C. Kwong, F.B. Jamieson, T.K. Marras); University Health Network and Sinai Health System, Toronto (S.K. Brode, T.K. Marras); Toronto Western Family Health Team, Toronto (J.C. Kwong); Public Health Ontario, Toronto (J.C. Kwong, A. Marchand-Austin, F.B. Jamieson); Oregon Health and Science University, Portland, Oregon, USA (K.L. Winthrop)

Main Article

Table 1

Baseline characteristics of patients who did and did not receive treatment for MAC PD and M. xenopi PD, Ontario, Canada, 2001–2013*

Characteristic MAC PD
M. xenopi PD
Treated, n = 688† Untreated, n = 2,146 p value Treated, n = 142† Untreated, n = 786 p value
Sex 0.031 0.248
F 409 (59.4) 1,175 (54.8) 61 (43.0) 380 (48.1)
279 (40.6)
971 (45.2)

81 (57.0)
407 (51.8)

Age, mean ± SD
75.6 ± 5.94
76.9 ± 6.65

75.1 ± 5.92
76.1 ± 6.50
Income quintile 0.018 0.932
1 (lowest) 142 (20.6) 550 (25.6) 32 (22.5) 164 (20.9)
2 146 (21.2) 428 (19.9) 33 (23.2) 178 (22.6)
3 124 (18.0) 425 (19.8) 26 (18.3) 131 (16.7)
4 117 (17.0) 354 (16.5) 24 (16.9) 157 (20.0)
5 (highest) 155–159 (22.5–23.1) 382 (17.8) 22–27 (15.5–19.01) 153–158 (19.5–20.1)
<5 (<0.7)
7 (0.3)

<5 (<3.5)
<5 (<0.7)

Residency‡ <0.001 0.288
Rural 37 (5.4) 53 (2.5) ≤5 (≤3.5) 8 (1.0)
Suburban 89 (12.9) 159 (7.4) 9–14 (6.3–9.9) 38 (4.8)
562 (81.7)
1,934 (90.1)

129 (90.8)
740 (94.1)

ADGs, mean ± SD
10.4 ± 3.49
10.4 ± 3.67

11.3 ± 3.52
10.8 ± 3.77
Underlying conditions§
Asthma 265 (38.5) 751 (35.0) 0.094 64 (45.1) 311 (39.6) 0.219
Bronchiectasis 169 (24.6) 335 (15.6) <0.001 19 (13.4) 90 (11.5) 0.511
Chronic kidney disease 40 (5.8) 199 (9.3) 0.004 12 (8.5) 66 (8.4) 0.983
COPD 462 (67.2) 1,209 (56.3) <0.001 118 (83.1) 474 (60.3) <0.001
Cystic fibrosis <5 (<0.7) <5 (<0.2) 0.327 <5 (<3.5) <5 (<0.6) 0.172
Diabetes mellitus 121 (17.6) 518 (24.1) <0.001 28 (19.7) 206 (26.2) 0.101
GERD 139 (20.2) 429 (20.0) 0.903 31 (21.8) 158 (20.1) 0.638
HIV infection <5 (≤0.7) <5 (<0.2) 0.087 0 0 NA
Interstitial lung disease 81 (11.8) 138 (6.4) <0.001 14 (9.9) 62 (7.9) 0.430
Lung cancer 19 (2.8) 135 (6.3) <0.001 9 (6.3) 74 (9.4) 0.237
Prior TB <5 (<0.7) 17 (0.8) 0.161 <5 (<3.5) 12 (1.5) 0.915
Rheumatoid arthritis 27 (3.9) 79 (3.7) 0.770 6 (4.2) 31 (3.9) 0.875

*Values are no. (%) except as indicated. According to privacy regulations, values representing <6 persons are reported as <5, and data are presented as a range of values for categorical variables where back-calculation is possible. ADGs, aggregated diagnostic groups (from the adjusted clinical group case mix system); COPD, chronic obstructive pulmonary disease; GERD, gastroesophageal reflux disease; MAC, Mycobacterium avium complex;, M. xenopi; Mycobacterium xenopi; NA, not applicable; PD, pulmonary disease; TB, tuberculosis.
†Treated defined as >60 continuous days of treatment with >1 drugs/classes commonly used to treat MAC or M. xenopi PD (macrolide, ethambutol, rifamycin, fluoroquinolone, linezolid, inhaled amikacin, or, for M. xenopi, isoniazid), started within 1 y of any positive culture for the causative nontuberculous mycobacteria species/complex.
‡Derived from rural index for Ontario group, a measure of rurality designed for Ontario (9).
§Defined according to inpatient and outpatient diagnostic codes in databases of hospital discharges and physicians’ services claims, respectively; see Appendix for definitions. Definitions have been validated for all underlying conditions with the exception of bronchiectasis and interstitial lung disease.

Main Article

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Page updated: June 17, 2019
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