Volume 28, Number 8—August 2022
Research
Increasing and More Commonly Refractory Mycobacterium avium Pulmonary Disease, Toronto, Ontario, Canada
Daan Raats1
, Sarah K. Brode, Mahtab Mehrabi, and Theodore K. Marras
, Sarah K. Brode, Mahtab Mehrabi, and Theodore K. Marras
Table 3
Antibiotic treatment in early and late period used for patients with Mycobacterium avium and M. xenopi pulmonary disease, Toronto, Ontario, Canada*
| Treatment | M. avium |
M. xenopi |
|||||
|---|---|---|---|---|---|---|---|
| Early period, n = 82 |
Late period, n = 138 |
p value | Early period, n = 24 |
Late period, n = 8 |
p value | ||
| Initial treatment | |||||||
| Macrolide | 82 (100) | 138 (100) | Referent | 23 (95.8) | 8 (100) | Referent | |
| Ethambutol | 78 (95.1) | 126 (91.3) | 0.42 | 21 (87.5) | 8 (100) | 0.55 | |
| Rifamycin | 51 (62.2) | 109 (79.0) | 0.008 | 14 (58.3) | 6 (75.0) | 0.68 | |
| Fluoroquinolone | 46 (56.1) | 18 (13.0) | <0.001 | 9 (37.5) | 3 (37.5) | Referent | |
| IV amikacin | 1 (1.2) | 2 (1.5) | Referent | 1 (4.2) | 0 | Referent | |
| Other |
0 |
2 (1.5)† |
0.53 |
2 (8.3)‡ |
0 |
Referent |
|
| Total initial drugs | |||||||
| 2 drugs | 2 (2.4) | 23 (16.7) | 0.001 | 5 (20.8) | 1 (12.5) | 0.66 | |
| 3 drugs | 67 (81.7) | 111 (80.4) | 16 (66.7) | 5 (62.5) | |||
| >3 drugs |
13 (15.9) |
4 (2.9) |
3 (12.5) |
2 (25.0) |
|||
| Amikacin added | |||||||
| IV | 20 (24.4) | 23 (16.7) | 0.62 | 7 (29.2) | 1 (12.5) | 0.68 | |
| Inhaled only |
1 (1.2) |
7 (5.1) |
2 (8.3) |
1 (12.5) |
|||
| Treatment adapted |
16 (19.5) |
36 (26.1) |
0.33 |
11 (45.8) |
3 (37.5) |
Referent |
|
| Treatment intensified |
7 (8.5) |
15 (10.9) |
0.65 |
9 (37.5) |
2 (25.0) |
0.68 |
|
| Median total duration, mo (IQR) | 21 (13.3–31.5) | 18 (13.0–28.8) | 0.38 | 15.5 (10.8–26.0) | 18 (10.8–20.5) | Referent | |
*Values are no. (%) except as indicated. Bold indicates significance. Drugs were counted toward initial treatment if started within the first 3 months of treatment. Changes in treatment were regarded as treatment adaptations if they took place after the first 3 months of treatment. Treatment adaptations were considered intensification if they resulted in a higher number of drugs used. IV, intravenous. †Clofazimine in 1 patient, inhaled amikacin in 1 patient. ‡Clofazimine in 1 patient, linezolid in 1 patient.
1Current affiliation: Ziekenhuis Oost-Limburg, Genk, Belgium.
Page created: June 14, 2022
Page updated: July 20, 2022
Page reviewed: July 20, 2022
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