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- Title
Old age is associated with worse treatment outcome and frequent adverse drug reaction in Mycobacterium avium complex pulmonary disease.
- Authors
Kim, Joong-Yub; Kim, Na Young; Jung, Hee-Won; Yim, Jae-Joon; Kwak, Nakwon
- Abstract
<bold>Background: </bold>The number of patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) is rapidly increasing globally, especially in the older population. However, there is a dearth of evidence regarding the impact of aging on the treatment outcomes of NTM-PD.<bold>Methods: </bold>We analyzed consecutive patients who satisfied the diagnostic criteria for Mycobacterium avium complex (MAC)-PD and received antibiotic treatment between January 2009 and December 2020 at a tertiary referral hospital in Korea. The main outcomes were (1) long-term treatment success, defined by negative culture conversion for more than 12 months; and (2) adverse drug reactions (ADRs). Multivariable logistic regression model was used to evaluate the association between age and main outcomes.<bold>Results: </bold>A total of 614 patients (median age, 65 years, interquartile range [IQR] 57-73 years; men, 35.3%) were included. Median treatment duration (530 days, IQR 290-678 days; P for trend < 0.001) and long-term treatment success (P for trend = 0.026) decreased, whereas ADRs (P for trend < 0.001) increased significantly with age. Multivariable analyses demonstrated that age ≥ 80 years was an independent factor associated with ADRs (adjusted odds ratio [aOR] 3.29; 95% confidence interval [CI] 1.05-10.28) and worse treatment outcome (aOR 0.42; 95% CI 0.19-0.91).<bold>Conclusions: </bold>Aging is associated with worse treatment outcome and frequent ADRs of patients with MAC-PD. Individualized treatment with reduced-intensity may be a reasonable alternative for older adults.
- Subjects
SOUTH Korea; DRUG side effects; MYCOBACTERIUM avium; OLD age; TREATMENT effectiveness; LUNG diseases; MYCOBACTERIUM avium paratuberculosis; ANTIBIOTIC prophylaxis
- Publication
BMC Pulmonary Medicine, 2022, Vol 22, Issue 1, p1
- ISSN
1471-2466
- Publication type
journal article
- DOI
10.1186/s12890-022-02063-2