Prescription habits and drugs accessibility for the treatment of non-tuberculous mycobacteria infections in Italy: a multicentric survey from the IRENE study group

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2024年9月20日

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Giacomo Stroffolini,
Tommaso Lupia,
Alberto Gaviraghi,
Francesco Venuti,
Giacoma Cinnirella,
Andrea Gori,
Maura Spotti,
Francesco Blasi,
Luigi Codecasa,
Andrea Calcagno,
Stefano Aliberti,
Marco Confalonieri,
Marco Contoli,
Federico Cresta,
Simona Cristadoro,
Emanuele Delfino,
Maurizio Ferrarese,
Filippo Gozzi,
Maria Gussio,
Enrica Intini,
Benedetta Longo,
Alberto Matteelli,
Jessica Mencarini,
Rossella Molinari,
Pier Anselmo Mori Pier,
Pietro Pirina,
Federica Poletti,
Niccolò Riccardi,
Marianna Rossi,
Andrea Sattin,
Elena Tagliabue

摘要

Purpose

Non-tuberculous mycobacteria (NTM) account for high clinical burden, and treatment can be challenging. Moreover, accessibility of NTM medications varies across centers. These challenges may lead to unplanned therapeutic changes, discontinuations, potentially affecting patient outcomes. Aim of this survey was to evaluate the accessibility of NTM-targeting drugs in Italy (with a particular focus on clofazimine) in centers associated with the IRENE Registry, a collaborative network of healthcare professionals.

Methods

A cross-sectional, internet-based, questionnaire-survey on the use and availability of clofazimineand other NTM-targeting drugs was sent to 88 principal investigators of the IRENE network in Italyin 2020. The questionnaires were designed with closed-ended and open-ended questions and distributed using the SurveyMonkey® platform.

Results

The surveys underscore the more frequent involvement of pulmonologists (42%) and infectious disease specialists (34%) in NTM treating strategies. Respondents were distributed across 18 out of20 Italian regions, with a significant concentration in the north, encompassing university hospitalsand outpatient clinics. Molecular testing is available in 40% of the involved centers, while phenotypic in 30% of the centers. Centers have a multidisciplinary team and an appointed pharmacy service for NTM drugs distribution in 10 and 75% of the cases, respectively. Substantial variability was observed in drug availability and accessibility, drug regimen composition, and drug dosage, particularly for medications like clofazimine.

Conclusions

This study shows the high heterogeneity of anti-NTM drug availability in Italy and prompts toward a harmonization in antibiotic prescription and access; it also emphasizes the challenges in determining the optimal therapeutic strategies for treating NTM-infections.