PT - JOURNAL ARTICLE AU - Saverio De Lorenzo AU - Jan Wilem Alffenaar AU - Giovanni Sotgiu AU - Rosella Centis AU - Lia D'Ambrosio AU - Simon Tiberi AU - Mathieu S. Bolhuis AU - Richard van Altena AU - Piero Viggiani AU - Andrea Piana AU - Antonio Spanevello AU - Giovanni Battista Migliori TI - Efficacy and safety of meropenem–clavulanate added to linezolid-containing regimens in the treatment of MDR-/XDR-TB AID - 10.1183/09031936.00124312 DP - 2013 Jun 01 TA - European Respiratory Journal PG - 1386--1392 VI - 41 IP - 6 4099 - http://erj.ersjournals.com/content/41/6/1386.short 4100 - http://erj.ersjournals.com/content/41/6/1386.full SO - Eur Respir J2013 Jun 01; 41 AB - Clinical experience on meropenem–clavulanate to treat tuberculosis (TB) is anecdotal (according to case reports on 10 patients). The aim of our case–control study was to evaluate the contribution of meropenem–clavulanate when added to linezolid-containing regimens in terms of efficacy and safety/tolerability in treating multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB cases after 3 months of second-line treatment. 37 cases with MDR-/XDR-TB were prescribed meropenem–clavulanate (3 g daily dose) in addition to a linezolid-containing regimen (dosage range 300–1200 mg·day−1), designed according to international guidelines, which was prescribed to 61 controls. The clinical severity of cases was worse than that of controls (drug susceptibility profile, proportion of sputum-smear positive and of re-treatment cases). The group of cases yielded a higher proportion of sputum-smear converters (28 (87.5%) out of 32 versus nine (56.3%) out of 16; p=0.02) and culture converters (31 (83.8%) out of 37 versus 15 (62.5%) out of 24; p=0.06). Excluding XDR-TB patients (11 (11.2%) out of 98), cases scored a significantly higher proportion of culture converters than controls (p=0.03). One case had to withdraw from meropenem–clavulanate due to increased transaminase levels. The results of our study provide: 1) preliminary evidence on effectiveness and safety/tolerability of meropenem–clavulanate; 2) reference to design further trials; and 3) a guide to clinicians for its rationale use within salvage/compassionate regimens.