Multicenter, retrospective cohort study of antimycobacterial treatment-related harms among patients with non-tuberculosis Mycobacterium infections in the United States

• DOI: 10.1128/aac.01596-24
• Publication Date: 2025-03-04T14:00:30Z
• Authors: Michael P. Veve; Rachel M. Kenney; Alisar M. Aljundi; Michelle S. Dierker; Vasilios Athans; Anita B. Shallal; Nimish Patel
• Keywords: Discontinuation; Regimen

ABSTRACT Non-tuberculosis mycobacteria (NTM) are extensively drug-resistant organisms that require long-term therapy. The study purpose was to quantify the incidence of and risk factors for antimycobacterial-associated adverse drug events (ADEs) in persons with NTM infections receiving outpatient A multicenter, retrospective cohort performed who received antimycobacterial treatment from 2013 2024. Inclusion criteria were age ≥18 years, ≥1 month treatment, follow-up visit within 3 months index encounter. Mycobacterium avium complex tuberculosis excluded. primary outcome development pre-specified treatment-related ADE or acute kidney injury (AKI), thrombocytopenia, and/or Clostridioides difficile infection (CDI) through 12 Secondary outcomes included therapy discontinuation due any ADEs. Two hundred patients included: 14% developed a ADE. abscessus (29%) most common pathogen; initial regimens macrolide (54%), systemic aminoglycoside (24%), β-lactam tetracycline derivative (22%). ADEs thrombocytopenia (9%), AKI (8%), CDI (<1%). median (IQR) time-to-ADE 25 (18–38) days regimen; aminoglycoside- oxazolidinone-based therapies more likely develop (adjOR, 3.9; 95% CI, 1.7–9.2). Therapy occurred 35% patients; time-to-any 32 (21–58) days. occur near first treatment. Intensified monitoring use tolerable early may be an appropriate approach avoid harms. Treatment non-tuberculosis is complicated by (ADEs). This work quantified time course pre-determined, clinically relevant (acute injury, C. infection), which 30