PT  - JOURNAL ARTICLE
AU  - Jakko van Ingen
AU  - Jennifer Adjemian
AU  - Kozo Morimoto
AU  - Dirk Wagner
AU  - Christoph Lange
AU  - Charles Haworth
AU  - Jack Gallagher
AU  - D. Rebecca Prevots
AU  - Renu Gupta
AU  - David Griffith
TI  - Comparison of treatment practices for nontuberculous mycobacterial pulmonary disease in Japan, Europe, and United States
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P1066
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P1066.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P1066.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background: Recent data from the United States (US) suggest limited adherence to 3-drug regimen guidelines to treat nontuberculous mycobacterial pulmonary disease (NTMPD) patients (pts) with Mycobacterium avium complex (MAC). We performed chart audits to evaluate whether clinicians in Europe and Japan adhere to the guidelines.Methods: Representative samples of physicians from Japan and 5 countries in Europe (EU5: United Kingdom [UK], France, Germany, Italy, and Spain) extracted treatment information from records of NTMPD pts with a confirmed diagnosis of MAC or M. abscessus. Treatment patterns in EU5 and Japan were compared to published US data.Results: In the EU5 and Japan, 619 qualified physicians with NTMPD pts completed questionnaires on 1,429 patient cases; the US study included 349 physicians with 915 patient cases. MAC (∼80%) was the predominant species in all countries. Pts in Japan presented mostly with mild symptoms; elsewhere patients presented with moderate symptoms. Treatment for MAC with a recommended 3-drug macrolide regimen for ≥6 months was highest in Japan (50%), similar in US (24%) and UK (22%), and <8% in all other countries. Aside from France, a higher percentage of pts in EU5 (68%) received treatment with any antibiotic compared with US (53%) and Japan (43%). Oral antibiotics were the treatment of choice (87%); patients in Japan (11%) were less likely to receive intravenous antibiotics than in US (21%) and EU5 (31%).Conclusions: Guidance-compliant treatment regimen was highest in Japan. Further investigation is warranted to address critical gaps in appropriate treatment practices.