A Survey of Clarithromycin Monotherapy for Patients with MAC Lung Disease in Japan

Abstract

Background The number of patients with nontuberculous mycobacteriosis (NTM) has increased exponentially in recent years. In Japan, approximately 88.8% of patients with NTM suffer from Mycobacterium avium-intracellulare complex (MAC) Lung Disease. Incidence of MAC Lung Disease is increasing owing to a rapid increase in nontuberculous mycobacterial infections. Although basic treatment for MAC Lung Disease is chemotherapy, clarithromycin monotherapy is contraindicated by specialists owing to its high potential to induce drug-resistant bacterial strains in patients with MAC Lung Disease. However, it is unclear how much such treatment cases exist in clinical practical. This is because no long-term investigation has been carried out. Materials and Methods This study investigated treatment with these medications from 2005 to 2017, by studying 1107 patients with MAC Lung Disease based on data in patient insurance claims. Results Results showed that approximately 10.3% (114 cases) were prescribed long-term CAM monotherapy for three months. Conclusion Generally, administration of antibiotics over a long period of time is potentially detrimental to some patients. Better awareness of the types of treatments and their potential negative effects will be beneficial to clinical practitioners. In the immediate future, it seems to be effective to develop an educational system on single agent administration of antimicrobial agents.