Old age is associated with worse treatment outcome and frequent adverse drug reaction in Mycobacterium avium complex pulmonary disease.
BMC Pulm Med
; 22(1): 269, 2022 Jul 14.
Article
en En
| MEDLINE
| ID: mdl-35836160
ABSTRACT
BACKGROUND:
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.METHODS:
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.RESULTS:
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).CONCLUSIONS:
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.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Infección por Mycobacterium avium-intracellulare
/
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos
/
Enfermedades Pulmonares
/
Infecciones por Mycobacterium no Tuberculosas
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
BMC Pulm Med
Año:
2022
Tipo del documento:
Article