OBJECTIVES: The goal of this study was to analyze the baseline characteristics and management of NTMLD patients in community care in Germany.

METHODS: This retrospective study is based on IMS Disease Analyzer data (IQVIA), which compiles of drug prescriptions, diagnoses, basic medical and demographic data obtained directly and in anonymous format from general practitioners (GP) and office-based pulmonologists (PN) in Germany. This study included patients with an initial confirmed diagnosis of pulmonary mycobacterial infection (ICD-10: A31.0), other mycobacterial infection (ICD-10: A31.8), or unspecified mycobacterial infection (ICD-10: A31.9), documented between October 1, 2014 and September 30, 2019, and an observation time of at least 12 months prior to and a follow-up time of at least 12 months after the index date.

RESULTS: A total of 395 different patients (159 patients treated by 125 GPs and 236 patients treated by 31 PNs) were analyzed. Mean ages of patients were 59 (GPs) and 62 (PNs) years; 51% and 58% of patients managed by GPs and PNs, respectively, were female. A total of 40% and 45% of the diagnosed by GP and PN patients, received an antibiotic regimen for NTMLD. This therapy lasted for at least 6 months in 42% of patients, only 24% received antibiotics for at least 12 months and 8% were still on therapy after 18 months. The average therapy duration was longer in patients treated by PNs (241 days) than in patients treated by GPs (113 days) and 27% and 63% of treated NTMLD patients managed by GPs and PN, received guideline-based therapies (GBT) at least once. Finally, almost all patients (100% in GP, 96% in PN practice) also received non-GBT regimens.

CONCLUSIONS: NTMLD management in community care setting in Germany should be improved through appropriate referral pathways and collaboration between expert centers and community care physicians.