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Effectiveness and safety of meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB.
Tiberi, Simon; Payen, Marie-Christine; Sotgiu, Giovanni; D'Ambrosio, Lia; Alarcon Guizado, Valentina; Alffenaar, Jan Willem; Abdo Arbex, Marcos; Caminero, Jose A; Centis, Rosella; De Lorenzo, Saverio; Gaga, Mina; Gualano, Gina; Roby Arias, Aurora Jazmín; Scardigli, Anna; Skrahina, Alena; Solovic, Ivan; Sulis, Giorgia; Tadolini, Marina; Akkerman, Onno W; Alarcon Arrascue, Edith; Aleska, Alena; Avchinko, Vera; Bonini, Eduardo Henrique; Chong Marín, Félix Antonio; Collahuazo López, Lorena; de Vries, Gerard; Dore, Simone; Kunst, Heinke; Matteelli, Alberto; Moschos, Charalampos; Palmieri, Fabrizio; Papavasileiou, Apostolos; Spanevello, Antonio; Vargas Vasquez, Dante; Viggiani, Pietro; White, Veronica; Zumla, Alimuddin; Migliori, Giovanni Battista.
Afiliação
  • Tiberi S; Division of Infection, Barts Healthcare NHS Trust, London, UK These authors contributed equally to this work.
  • Payen MC; Division of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium These authors contributed equally to this work.
  • Sotgiu G; Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari - Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy These authors contributed equally to this work.
  • D'Ambrosio L; WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy Public Health Consulting Group, Lugano, Switzerland These authors contributed equally to this work.
  • Alarcon Guizado V; National Tuberculosis Control Programme, Ministry of Health, Lima, Peru.
  • Alffenaar JW; Dept of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Abdo Arbex M; University Center of Araraquara, Sao Paulo, Brazil Hospital Nestor Goulart Reis, Sao Paulo State Secretary of Health, Sao Paulo, Brazil.
  • Caminero JA; Pneumology Dept, Hospital General de Gran Canaria "Dr. Negrin", Las Palmas de Gran Canaria, Spain MDR-TB Unit, Tuberculosis Division, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.
  • Centis R; WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy.
  • De Lorenzo S; AOVV E. Morelli Hospital, Reference Hospital for MDR and HIV-TB, Sondalo, Italy.
  • Gaga M; MDR-TB Unit, Athens Chest Hospital Sotiria, National Referral Centre for Mycobacteria, Athens, Greece.
  • Gualano G; Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy.
  • Roby Arias AJ; National Tuberculosis Control Programme, Pulmonology Hospital Alfredo J. Valenzuela, Guayaquil, Ecuador.
  • Scardigli A; MDR-TB Unit, Tuberculosis Division, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.
  • Skrahina A; Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus.
  • Solovic I; National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Slovakia.
  • Sulis G; University Dept of Infectious and Tropical Diseases, WHO Collaborating Centre for TB/HIV Co-infection and for TB Elimination - University of Brescia and Brescia Spedali Civili General Hospital, Brescia, Italy.
  • Tadolini M; Unit of Infectious Diseases, Dept of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
  • Akkerman OW; Dept of Pulmonary Diseases and Tuberculosis, TB Center Beatrixoord, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Alarcon Arrascue E; MDR-TB Unit, Tuberculosis Division, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France International Union Against Tuberculosis and Lung Disease (The Union), Lima, Peru.
  • Aleska A; Educational Institution "Grodno State Medical University", Grodno, Belarus.
  • Avchinko V; Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus.
  • Bonini EH; University Center of Araraquara, Sao Paulo, Brazil Hospital Nestor Goulart Reis, Sao Paulo State Secretary of Health, Sao Paulo, Brazil.
  • Chong Marín FA; National Tuberculosis Control Programme, Pulmonology Hospital Alfredo J. Valenzuela, Guayaquil, Ecuador.
  • Collahuazo López L; National Tuberculosis Control Programme, Pulmonology Hospital Alfredo J. Valenzuela, Guayaquil, Ecuador.
  • de Vries G; KNCV Tuberculosis Foundation, The Hague, The Netherlands.
  • Dore S; Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari - Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy.
  • Kunst H; Dept of Respiratory Medicine, Queen Mary University, London, UK.
  • Matteelli A; University Dept of Infectious and Tropical Diseases, WHO Collaborating Centre for TB/HIV Co-infection and for TB Elimination - University of Brescia and Brescia Spedali Civili General Hospital, Brescia, Italy.
  • Moschos C; MDR-TB Unit, Athens Chest Hospital Sotiria, National Referral Centre for Mycobacteria, Athens, Greece.
  • Palmieri F; Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy.
  • Papavasileiou A; MDR-TB Unit, Athens Chest Hospital Sotiria, National Referral Centre for Mycobacteria, Athens, Greece.
  • Spanevello A; Pneumology Unit, Fondazione Maugeri, IRCCS, Tradate, Italy Dept of Clinical and Experimental Medicine, University of Insubria, Varese, Italy.
  • Vargas Vasquez D; National Hospital Hipólito Unanue, Public Health Institute, Ministry of Health, Lima, Peru.
  • Viggiani P; AOVV E. Morelli Hospital, Reference Hospital for MDR and HIV-TB, Sondalo, Italy.
  • White V; Dept of Respiratory Medicine, Barts Healthcare NHS Trust, London, UK.
  • Zumla A; Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK.
  • Migliori GB; WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy giovannibattista.migliori@fsm.it.
Eur Respir J ; 47(4): 1235-43, 2016 Apr.
Article em En | MEDLINE | ID: mdl-26965290
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 (6-9)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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tienamicinas / Tuberculose Resistente a Múltiplos Medicamentos / Ácido Clavulânico / Tuberculose Extensivamente Resistente a Medicamentos / Antituberculosos Idioma: En Ano de publicação: 2016 Tipo de documento: Article
Texto completo
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tienamicinas / Tuberculose Resistente a Múltiplos Medicamentos / Ácido Clavulânico / Tuberculose Extensivamente Resistente a Medicamentos / Antituberculosos Idioma: En Ano de publicação: 2016 Tipo de documento: Article