| Titre : |
Effectiveness and safety of meropenem / clavulanate-containing regimens in the treatment of MDR- and XDR-TB |
| Type de document : |
document électronique |
| Auteurs : |
Simon Tiberi, Auteur ; Marie-Christine Payen, Auteur ; Giovanni Sotgiu, Auteur |
| Editeur : |
European Respiratory Society (ERS) |
| Année de publication : |
2016 |
| Collection : |
European Respiratory Journal num. vol.47 nr 4 |
| Importance : |
p.1235-1243 |
| Langues : |
Anglais (eng) |
| Catégories : |
[TUBER] étude
[TUBER] traitement:résistance
|
| Index. décimale : |
TU 8.5.1. MDR (Multi Drug Resistance / XDR (X-treme Drug Resistance) |
| Résumé : |
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. |
| En ligne : |
https://doi.org/10.1183/13993003.02146-2015 |
| Format de la ressource électronique : |
Article en ligne |
| Permalink : |
https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10150 |
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