RT Journal Article
SR Electronic
T1 Effectiveness and safety of meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1235
OP 1243
DO 10.1183/13993003.02146-2015
VO 47
IS 4
A1 Simon Tiberi
A1 Marie-Christine Payen
A1 Giovanni Sotgiu
A1 Lia D'Ambrosio
A1 Valentina Alarcon Guizado
A1 Jan Willem Alffenaar
A1 Marcos Abdo Arbex
A1 Jose A. Caminero
A1 Rosella Centis
A1 Saverio De Lorenzo
A1 Mina Gaga
A1 Gina Gualano
A1 Aurora Jazmín Roby Arias
A1 Anna Scardigli
A1 Alena Skrahina
A1 Ivan Solovic
A1 Giorgia Sulis
A1 Marina Tadolini
A1 Onno W. Akkerman
A1 Edith Alarcon Arrascue
A1 Alena Aleska
A1 Vera Avchinko
A1 Eduardo Henrique Bonini
A1 Félix Antonio Chong Marín
A1 Lorena Collahuazo López
A1 Gerard de Vries
A1 Simone Dore
A1 Heinke Kunst
A1 Alberto Matteelli
A1 Charalampos Moschos
A1 Fabrizio Palmieri
A1 Apostolos Papavasileiou
A1 Antonio Spanevello
A1 Dante Vargas Vasquez
A1 Pietro Viggiani
A1 Veronica White
A1 Alimuddin Zumla
A1 Giovanni Battista Migliori
YR 2016
UL http://erj.ersjournals.com/content/47/4/1235.abstract
AB 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 (6–9) versus 5 (4–6)). Patients were treated with a meropenem/clavulanate-containing regimen for a median (IQR) of 85 (49–156) 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