{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T02:15:57Z","timestamp":1768529757281,"version":"3.49.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background\/Aims<\/jats:title>\n                  <jats:p>Although increased mortality has been reported among people with Mycobacterium avium complex pulmonary disease (MAC-PD), data are limited on survival associated with various antibiotic regimens used to treat MAC-PD. We conducted a comparative analysis of 3-year mortality in Medicare beneficiaries with bronchiectasis using various MAC-PD regimens.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included Medicare beneficiaries aged \u226565 years with bronchiectasis (01\/2006\u201312\/2014). We limited our cohort to new MAC-PD therapy users. MAC-PD therapy was defined as \u226560-day prescriptions for a macrolide plus \u22651 other MAC-PD antibiotic. Guideline-based therapy (GBT) included a macrolide, ethambutol, and\/or rifamycin. Using Cox proportional hazard models, we calculated adjusted hazard ratios (aHR) for death up to 3 years after therapy start between the following groups: (1) 2007 GBT versus non-GBT; (2) 2020 GBT versus non-GBT; and (3) macrolide-ethambutol-rifamycin (3-drug) versus macrolide-ethambutol (2-drug).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 4820 new MAC-PD therapy users, of whom 866 (17.9%) were deceased within 3 years of therapy initiation. Of 3040 (63.1%) beneficiaries prescribed 2007 GBT, 472 (15.5%) were deceased by 3 years, compared to 394 (22.1%) of 1780 (36.9%) prescribed non-GBT (aHR 0.82; 95% confidence interval [CI], .72\u2013.94). We observed a similar trend for 2020 GBT versus non-GBT (aHR 0.81; 95% CI, .70\u2013.94]). Three-year-mortality was similar between those starting 3-drug versus 2-drug regimens (aHR 0.89; 95% CI, .74\u20131.08]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among Medicare new MAC-PD therapy users, 3-year-mortality was higher in those prescribed non-GBT regimens compared to GBT regimens. Whether this finding suggests improved efficacy of GBT and\/or differential characteristic of those using non-GBT regimens deserves further study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae639","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T15:12:46Z","timestamp":1730905966000},"source":"Crossref","is-referenced-by-count":3,"title":["<i>The Long and Winding Road<\/i>: Three-year Mortality Following Prescription of Multidrug Antibiotic Treatment for <i>Mycobacterium avium complex<\/i> Pulmonary Disease in United States Medicare Beneficiaries With Bronchiectasis"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3209-4489","authenticated-orcid":false,"given":"Cara D","family":"Varley","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University , Portland, Oregon ,","place":["USA"]},{"name":"Center for Infectious Disease Studies, Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9469-5875","authenticated-orcid":false,"given":"Jennifer H","family":"Ku","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Studies, Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA"},{"name":"Department of Research & Evaluation, Kaiser Permanente Southern California Medical Group , Pasadena, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Henkle","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Studies, Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Strnad","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University , Portland, Oregon ,","place":["USA"]},{"name":"Center for Infectious Disease Studies, Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3892-6947","authenticated-orcid":false,"given":"Kevin L","family":"Winthrop","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University , Portland, Oregon ,","place":["USA"]},{"name":"Center for Infectious Disease Studies, Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,6]]},"reference":[{"key":"2024112308510669700_ofae639-B1","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1164\/rccm.201003-0503OC","article-title":"Pulmonary nontuberculous mycobacterial disease prevalence and clinical features: an emerging public health disease","volume":"182","author":"Winthrop","year":"2010","journal-title":"Am J Respir Crit Care Med"},{"key":"2024112308510669700_ofae639-B2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/ciaa241","article-title":"Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS\/ERS\/ESCMID\/IDSA clinical practice guideline","volume":"71","author":"Daley","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2024112308510669700_ofae639-B3","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1111\/j.1365-2672.2009.04161.x","article-title":"Surrounded by mycobacteria: nontuberculous mycobacteria in the human environment","volume":"107","author":"Falkinham","year":"2009","journal-title":"J Appl Microbiol"},{"key":"2024112308510669700_ofae639-B4","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1164\/rccm.200604-571ST","article-title":"An official ATS\/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases","volume":"175","author":"Griffith","year":"2007","journal-title":"Am J Respir Crit Care Med"},{"key":"2024112308510669700_ofae639-B5","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.1513\/AnnalsATS.201605-344BC","article-title":"Relapse versus reinfection of Mycobacterium avium complex pulmonary disease. 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