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. 2014 Jan;11(1):9–16. doi: 10.1513/AnnalsATS.201304-085OC

Table 3.

Antibiotic regimens prescribed to patients treated for Mycobacterium avium complex by physician specialty

  Regimens Prescribed to Patients with MAC by Treating Physician Specialty
 
Infectious Disease
Pulmonology
Family/General Practice and Internal Medicine
Treatment Regimen n (%) n (%) n (%)
Total number of regimens prescribed (mean # regimens per patient) 194 (1.5) 237 (2.0) 88 (1.5)
Treatment regimens meeting ATS/IDSA guidelines 20 (10) 42 (18) 8 (9)
 Macrolide, ethambutol, and rifamycin 19 (10) 41 (17) 8 (9)
 Macrolide, ethambutol, rifamycin, and parenteral aminoglycoside 1 (0.5) 1 (0.4)
Treatment regimens not meeting ATS/IDSA guidelines for MAC* 174 (90) 195 (82) 80 (91)
 Treatment regimens that may increase macrolide resistance 45 (23) 95 (40) 20 (23)
  Macrolide monotherapy 23 (12) 51 (22) 10 (11)
  Macrolide plus fluoroquinolone 4 (2) 3 (1) 1 (1)
  Macrolide plus rifampin 18 (9) 41 (17) 9 (10)
 Treatment regiments that are of unknown clinical significance 3 (2)
  Macrolide plus inhaled amikacin 1 (0.5)
  Macrolide plus linezolid 2 (1)
 Treatment regimens that do not include macrolides 126 (65) 100 (42) 60 (68)
  Ethambutol plus rifamycin 35 (18) 53 (22) 17 (19)
  Fluoroquinolone based regimen 44 (23) 25 (11) 13 (15)
  Parenteral aminoglycoside based regimen 1 (0.5) 1 (0.4) 10 (11)
  Linezolid based regimen 1 (0.5)
  Any nonmacrolide antibiotic monotherapy regimen 45 (23) 21 (9) 20 (23)

Definition of abbreviations: ATS = American Thoracic Society; IDSA = Infectious Diseases Society of America; MAC = Mycobacterium avium complex.

Patients with treatment regimens overseen by more than one physician specialty type or by physician specialties other than those listed were excluded from this table (n = 44). Macrolides include clarithromycin and azithromycin; rifamycins include rifampin and rifabutin; parenteral aminoglycosides include streptomycin and amikacin; and fluorquinolones include ofloxacin, ciprofloxacin, levofloxacin, and moxifloxacin.

*

There are currently no drug regimens of proven efficacy for the treatment of M. abscessus lung disease according to the 2007 ATS/IDSA guidelines (6).