@article {Tiberi1235, author = {Simon Tiberi and Marie-Christine Payen and Giovanni Sotgiu and Lia D{\textquoteright}Ambrosio and Valentina Alarcon Guizado and Jan Willem Alffenaar and Marcos Abdo Arbex and Jose A. Caminero and Rosella Centis and Saverio De Lorenzo and Mina Gaga and Gina Gualano and Aurora Jazm{\'\i}n Roby Arias and Anna Scardigli and Alena Skrahina and Ivan Solovic and Giorgia Sulis and Marina Tadolini and Onno W. Akkerman and Edith Alarcon Arrascue and Alena Aleska and Vera Avchinko and Eduardo Henrique Bonini and F{\'e}lix Antonio Chong Mar{\'\i}n and Lorena Collahuazo L{\'o}pez and Gerard de Vries and Simone Dore and Heinke Kunst and Alberto Matteelli and Charalampos Moschos and Fabrizio Palmieri and Apostolos Papavasileiou and Antonio Spanevello and Dante Vargas Vasquez and Pietro Viggiani and Veronica White and Alimuddin Zumla and Giovanni Battista Migliori}, title = {Effectiveness and safety of meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB}, volume = {47}, number = {4}, pages = {1235--1243}, year = {2016}, doi = {10.1183/13993003.02146-2015}, publisher = {European Respiratory Society}, abstract = {No large study has ever evaluated the efficacy, safety and tolerability of meropenem/clavulanate to treat multidrug- and extensively drug-resistant tuberculosis (MDR- and XDR-TB). The aim of this observational study was to evaluate the therapeutic contribution, effectiveness, safety and tolerability profile of meropenem/clavulanate added to a background regimen when treating MDR- and XDR-TB cases.Patients treated with a meropenem/clavulanate-containing regimen (n=96) showed a greater drug resistance profile than those exposed to a meropenem/clavulanate-sparing regimen (n=168): in the former group XDR-TB was more frequent (49\% versus 6.0\%, p\<0.0001) and the median (interquartile range (IQR)) number of antibiotic resistances was higher (8 (6{\textendash}9) versus 5 (4{\textendash}6)). Patients were treated with a meropenem/clavulanate-containing regimen for a median (IQR) of 85 (49{\textendash}156) days.No statistically significant differences were observed in the overall MDR-TB cohort and in the subgroups with and without the XDR-TB patients; in particular, sputum smear and culture conversion rates were similar in XDR-TB patients exposed to meropenem/clavulanate-containing regimens (88.0\% versus 100.0\%, p=1.00 and 88.0\% versus 100.0\%, p=1.00, respectively). Only six cases reported adverse events attributable to meropenem/clavulanate (four of them then restarting treatment).The nondifferent outcomes and bacteriological conversion rate observed in cases who were more severe than controls might imply that meropenem/clavulanate could be active in treating MDR- and XDR-TB cases.Meropenem/clavulanate is effective and safe to treat MDR- and XDR-TB in comparison with controls http://ow.ly/XG75j}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/47/4/1235}, eprint = {https://erj.ersjournals.com/content/47/4/1235.full.pdf}, journal = {European Respiratory Journal} }