1. Comparison of effectiveness and safety of imipenem/clavulanate- versus meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB
- Author
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Fabrizio Palmieri, Aurora Jazmín Roby Arias, Alena Skrahina, Gina Gualano, Giovanni Sotgiu, Dante Vargas Vasquez, Eduardo Henrique Bonini, Marina Tadolini, Gerard de Vries, Saverio De Lorenzo, Jose A. Caminero, Pietro Viggiani, Marcos Abdo Arbex, Valentina Alarcon Guizado, Apostolos Papavasileiou, Lorena Collahuazo López, Simon Tiberi, Simone Dore, Andrea Piana, Anna Scardigli, Vera Auchynka, Marie-Christine Payen, Antonio Spanevello, Felix Antonio Chong Marin, Alena Aleksa, Edith Alarcon Arrascue, Janina Artsukevich, Heinke Kunst, Alberto Matteelli, Onno W. Akkerman, Giorgia Sulis, Alimuddin Zumla, Giovanni Battista Migliori, Lia D'Ambrosio, Ivan Solovic, Jan-Willem C. Alffenaar, Mina Gaga, Charalampos Moschos, Veronica White, Rosella Centis, Tiberi, Simon, Sotgiu, Giovanni, D'Ambrosio, Lia, Centis, Rosella, Arbex, Marcos Abdo, Arrascue, Edith Alarcon, Alffenaar, Jan Willem, Caminero, Jose A., Gaga, Mina, Gualano, Gina, Skrahina, Alena, Solovic, Ivan, Sulis, Giorgia, Tadolini, Marina, Guizado, Valentina Alarcon, De Lorenzo, Saverio, Arias, Aurora Jazmín Roby, Scardigli, Anna, Akkerman, Onno W., Aleksa, Alena, Artsukevich, Janina, Auchynka, Vera, Bonini, Eduardo Henrique, Marín, Félix Antonio Chong, López, Lorena Collahuazo, De Vries, Gerard, Dore, Simone, Kunst, Heinke, Matteelli, Alberto, Moschos, Charalampo, Palmieri, Fabrizio, Papavasileiou, Apostolo, Payen, Marie-Christine, Piana, Andrea, Spanevello, Antonio, Vasquez, Dante Varga, Viggiani, Pietro, White, Veronica, Zumla, Alimuddin, Migliori, Giovanni Battista, and Microbes in Health and Disease (MHD)
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Imipenem ,medicine.drug_class ,DELAMANID ,Antibiotics ,Drug resistance ,MULTIDRUG-RESISTANT ,Meropenem ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,COMPASSIONATE USE ,polycyclic compounds ,Culture conversion ,MEROPENEM-CLAVULANATE ,Medicine ,030212 general & internal medicine ,business.industry ,Medicine (all) ,DRUG-RESISTANT TUBERCULOSIS ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,EFFICACY ,BEDAQUILINE ,Multiple drug resistance ,030228 respiratory system ,Tolerability ,TOLERABILITY ,MYCOBACTERIUM-TUBERCULOSIS ,Delamanid ,business ,LINEZOLID SAFETY ,medicine.drug - Abstract
No large study to date has ever evaluated the effectiveness, safety and tolerability of imipenem/clavulanateversusmeropenem/clavulanate to treat multidrug- and extensively drug-resistant tuberculosis (MDR- and XDR-TB). The aim of this observational study was to compare the therapeutic contribution of imipenem/clavulanateversusmeropenem/clavulanate added to background regimens to treat MDR- and XDR-TB cases.84 patients treated with imipenem/clavulanate-containing regimens showed a similar median number of antibiotic resistances (8versus8) but more fluoroquinolone resistance (79.0%versus48.9%, pversus49.0%, p=0.01) in comparison with 96 patients exposed to meropenem/clavulanate-containing regimens. Patients were treated with imipenem/clavulanate- and meropenem/clavulanate-containing regimens for a median (interquartile range) of 187 (60–428)versus85 (49–156) days, respectively.Statistically significant differences were observed on sputum smear and culture conversion rates (79.7%versus94.8%, p=0.02 and 71.9%versus94.8%, pversus77.5%, p=0.03). Adverse events to imipenem/clavulanate and meropenem/clavulanate were reported in 5.4% and 6.5% of cases only.Our study suggests that meropenem/clavulanate is more effective than imipenem/clavulanate in treating MDR/XDR-TB patients.
- Published
- 2016