{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:27:51Z","timestamp":1791314871579,"version":"4.3.1"},"reference-count":36,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T00:00:00Z","timestamp":1601596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Incidence rates of pulmonary nontuberculous mycobacterial (NTM) disease have been increasing, especially in the elderly population. Given the limited evidence regarding the safety and efficacy of NTM treatment, this study aimed to evaluate the same among elderly patients. Material and methods: Patients diagnosed with NTM disease at a tertiary hospital from January 2007 to December 2017 were enrolled and data were then retrospectively collected. Data of elderly patients who received antimycobacterial treatment were then analyzed. Results: A total of 161 patients satisfied the diagnostic criteria for NTM disease. There were 40 elderly patients who received treatments. Of the patients, 60% received the guideline oriented standard regimens. Single drug regimens were administered to 22.5% of patients. Only 55.0% of the patients were able to continue any treatment. Treatment-related discontinuation was observed in 44.4% of discontinued or changed patients. There were no significant differences in the characteristics of patients with or without adverse events. Patients who were able to continue the treatment for &gt;12 months had a lower proportion of activities of daily living (ADL) disability (nine in 18, 50.0% vs. three in 22, 13.6%, p = 0.018) and heart disease (six in 18, 33.3% vs. 1\/22, 4.6%, p = 0.033). Sputum culture conversion was achieved in 28 out of 40 (70.0%) elderly patients treated, and those who achieved sputum culture conversion had more standard regimens prescribed than those who failed sputum culture conversion (21 in 28, 75% vs. 3 in 12, 25%; p = 0.005). Conclusion: Age may not be an obstacle for receiving the benefits of the treatment of NTM disease with a precise evaluation of patient\u2019s comorbidities. Furthermore, elderly patients without heart disease and ADL disability may have better rate of continuing the NTM treatment. The current study suggested that selecting standard regimens to treat pulmonary NTM is important for elderly patients.<\/jats:p>","DOI":"10.3390\/medicina56100517","type":"journal-article","created":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T09:39:25Z","timestamp":1601631565000},"page":"517","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Safety and Efficacy of Nontuberculous Mycobacteria Treatment among Elderly Patients"],"prefix":"10.3390","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7269-3956","authenticated-orcid":false,"given":"Yoshitaka","family":"Uchida","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo 142-8555, Japan"},{"name":"Department of Respirology, Asahi General Hospital, Chiba 289-2511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9019-4053","authenticated-orcid":false,"given":"Jiro","family":"Terada","sequence":"additional","affiliation":[{"name":"Department of Respirology, Asahi General Hospital, Chiba 289-2511, Japan"},{"name":"Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Homma","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo 142-8555, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatsuko","family":"Mikuni","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo 142-8555, Japan"},{"name":"Department of Respirology, Asahi General Hospital, Chiba 289-2511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuniaki","family":"Hirai","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo 142-8555, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhisa","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Respirology, Asahi General Hospital, Chiba 289-2511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoichi","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Respirology, Asahi General Hospital, Chiba 289-2511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironori","family":"Sagara","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo 142-8555, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.3201\/eid2206.151086","article-title":"Epidemiology of Pulmonary Nontuberculous Mycobacterial Disease, Japan1","volume":"22","author":"Namkoong","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1513\/AnnalsATS.201303-067OC","article-title":"A Steady Increase in Nontuberculous Mycobacteriosis Mortality and Estimated Prevalence in Japan","volume":"11","author":"Morimoto","year":"2014","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_3","first-page":"341","article-title":"Epidemiology of Adults and Children Treated for Nontuberculous Mycobacterial Pulmonary Disease in Japan","volume":"16","author":"Izumi","year":"2018","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1513\/AnnalsATS.201607-573OC","article-title":"A Laboratory-based Analysis of Nontuberculous Mycobacterial Lung Disease in Japan from 2012 to 2013","volume":"14","author":"Morimoto","year":"2017","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ccm.2014.10.002","article-title":"Epidemiology of human pulmonary infection with nontuberculous mycobacteria: A review","volume":"36","author":"Prevots","year":"2014","journal-title":"Clin. Chest Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e008058","DOI":"10.1136\/bmjopen-2015-008058","article-title":"Retrospective study of the predictors of mortality and radiographic deterioration in 782 patients with nodular\/bronchiectatic Mycobacterium avium complex lung disease","volume":"5","author":"Gochi","year":"2015","journal-title":"BMJ Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.rmed.2018.10.022","article-title":"Relative risk of all-cause mortality in patients with nontuberculous mycobacterial lung disease in a US managed care population","volume":"145","author":"Marras","year":"2018","journal-title":"Respir. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1164\/rccm.200905-0778OC","article-title":"Nontuberculous Pulmonary Mycobacteriosis in Denmark","volume":"181","author":"Thomsen","year":"2010","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1136\/thoraxjnl-2017-210927","article-title":"British Thoracic Society guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD)","volume":"72","author":"Haworth","year":"2017","journal-title":"Thorax"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1513\/AnnalsATS.201308-266OC","article-title":"Efficacy of Clarithromycin and Ethambutol forMycobacterium aviumComplex Pulmonary Disease. A Preliminary Study","volume":"11","author":"Miwa","year":"2014","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1164\/rccm.201408-1545OC","article-title":"Intermittent Antibiotic Therapy for Nodular BronchiectaticMycobacterium aviumComplex Lung Disease","volume":"191","author":"Jeong","year":"2015","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1136\/thx.51.12.1243","article-title":"Pulmonary Mycobacterium kansasii infection: Comparison of radiological appearances with pulmonary tuberculosis","volume":"51","author":"Evans","year":"1996","journal-title":"Thorax"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1183\/09031936.00024008","article-title":"Long-term relapses after 12-month treatment for Mycobacterium kansasii lung disease","volume":"33","author":"Santin","year":"2009","journal-title":"Eur. Respir. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"552","DOI":"10.3349\/ymj.2010.51.4.552","article-title":"Clinical Characteristics and Treatment Outcomes of Mycobacterium kansasiiLung Disease in Korea","volume":"51","author":"Park","year":"2010","journal-title":"Yonsei Med. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1378\/chest.129.3.771","article-title":"Pulmonary Mycobacterium kansasii Infection in Israel, 1999\u20132004","volume":"129","author":"Shitrit","year":"2006","journal-title":"Chest"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.rmed.2006.04.002","article-title":"A double-blind randomized study of aminoglycoside infusion with combined therapy for pulmonary Mycobacterium avium complex disease","volume":"101","author":"Kobashi","year":"2007","journal-title":"Respir. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1086\/378742","article-title":"Thrice-Weekly Clarithromycin-Containing Regimen for Treatment of Mycobacterium kansasii Lung Disease: Results of a Preliminary Study","volume":"37","author":"Griffith","year":"2003","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1136\/thorax.56.3.167","article-title":"Research First randomised trial of treatments for pulmonary disease caused by M avium intracellulare, M malmoense, and M xenopi in HIV negative patients: Rifampicin, ethambutol and isoniazid versus rifampicin and ethambutol","volume":"56","author":"Campbell","year":"2001","journal-title":"Thorax"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1136\/thx.2007.087999","article-title":"Clarithromycin vs ciprofloxacin as adjuncts to rifampicin and ethambutol in treating opportunist mycobacterial lung diseases and an assessment of Mycobacterium vaccae immunotherapy","volume":"63","author":"Jenkins","year":"2008","journal-title":"Thorax"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1378\/chest.13-2538","article-title":"Macrolide\/Azalide therapy for nodular\/bronchiectatic mycobacterium avium complex lung disease","volume":"146","author":"Wallace","year":"2014","journal-title":"Chest"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"(1994). Mycobacterium kansasii pulmonary infection: A prospective study of the results of nine months of treatment with rifampicin and ethambutol. Research Committee, British Thoracic Society. Thorax, 49, 442\u2013445.","DOI":"10.1136\/thx.49.5.442"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/0962-8479(95)90550-2","article-title":"Treatment of pulmonary disease caused by Mycobacterium kansasii: Results of 18 vs 12 months\u2019 chemotherapy","volume":"76","author":"Sauret","year":"1995","journal-title":"Tuber. Lung Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1136\/thx.38.4.271","article-title":"Pulmonary infection with Mycobacterium kansasii in Wales, 1970\u20131979: Review of treatment and response","volume":"38","author":"Banks","year":"1983","journal-title":"Thorax"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1164\/rccm.200603-450OC","article-title":"Clinical and Molecular Analysis of Macrolide Resistance inMycobacterium aviumComplex Lung Disease","volume":"174","author":"Griffith","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_25","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":"ref_26","doi-asserted-by":"crossref","first-page":"2000535","DOI":"10.1183\/13993003.00535-2020","article-title":"Treatment of nontuberculous mycobacterial pulmonary disease: An official ATS\/ERS\/ESCMID\/IDSA clinical practice guideline","volume":"56","author":"Daley","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1900798","DOI":"10.1183\/13993003.00798-2019","article-title":"Prognostic factors associated with long-term mortality in 1445 patients with nontuberculous mycobacterial pulmonary disease: A 15-year follow-up study","volume":"55","author":"Jhun","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.rmed.2018.10.023","article-title":"Quantitative assessment of erector spinae muscles in patients with Mycobacterium avium complex lung disease","volume":"145","author":"Asakura","year":"2018","journal-title":"Respir. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1093\/trstmh\/trt037","article-title":"Poor performance status is a strong predictor for death in patients with smear-positive pulmonary TB admitted to two Japanese hospitals","volume":"107","author":"Horita","year":"2013","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1111\/resp.12008","article-title":"Decreased activities of daily living is a strong risk factor for liver injury by anti-tuberculosis drugs","volume":"18","author":"Horita","year":"2013","journal-title":"Respirology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1093\/infdis\/jiy675","article-title":"Undernutrition and Tuberculosis: Public Health Implications","volume":"219","author":"Sinha","year":"2018","journal-title":"J. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e12463","DOI":"10.1097\/MD.0000000000012463","article-title":"Association between Mycobacterium avium complex lung disease and serum vitamin D status, antimicrobial peptide levels, and bone mineral density","volume":"97","author":"Fujita","year":"2018","journal-title":"Medicine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1111\/ggi.13740","article-title":"Comparison of three frailty models and a sarcopenia model in elderly patients with chronic obstructive pulmonary disease","volume":"19","author":"Hirai","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1164\/rccm.201503-0444OC","article-title":"Semiquantitative Culture Analysis during Therapy forMycobacterium aviumComplex Lung Disease","volume":"192","author":"Griffith","year":"2015","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/j.chest.2018.01.024","article-title":"Microbiologic Outcome of Interventions Against Mycobacterium avium Complex Pulmonary Disease","volume":"153","author":"Diel","year":"2018","journal-title":"Chest"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Baldwin, S.L., Larsen, S.E., Ordway, D., Cassell, G., and Coler, R.N. (2019). The complexities and challenges of preventing and treating nontuberculous mycobacterial diseases. PLoS Negl. Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007083"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/10\/517\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:15:54Z","timestamp":1760177754000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/10\/517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,2]]},"references-count":36,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["medicina56100517"],"URL":"https:\/\/doi.org\/10.3390\/medicina56100517","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,2]]}}}