par Tiberi, Simon;Gualano, Gina;Skrahina, Alena;Solovic, Ivan;Sulis, Giorgia;Tadolini, Marina;Alarcon Guizado, Valentina;De Lorenzo, Saverio;Roby Arias, Aurora Jazmín;Scardigli, Anna;Akkerman, Onno O.W.;Sotgiu, Giovanni;Aleksa, Alena;Artsukevich, Janina;Auchynka, Vera;Bonini, Eduardo Henrique;Chong Marín, Felix Antonio;Collahuazo López, Lorena;De Vries, Gérard;Dore, Simone;Kunst, Heinke;Matteelli, Alberto;D'Ambrosio, Lia;Moschos, Charalampos;Palmieri, Fabrizio;Papavasileiou, Apostolos;Payen, Marie-Christine ;Piana, Andrea;Spanevello, Antonio;Vargas Vasquez, Dante;Viggiani, Pietro;White, Veronica;Zumla, Alimuddin;Centis, Rosella;Migliori, Giovanni Battista;Arbex, Marcos Abdo;Alarcon Arrascue, Edith;Alffenaar, Jan Willem;Caminero, José Antonio;Gaga, Mina
Référence The European respiratory journal, 47, 6, page (1758-1766)
Publication Publié, 2016-06
Référence The European respiratory journal, 47, 6, page (1758-1766)
Publication Publié, 2016-06
Article révisé par les pairs
Résumé : | No large study to date has ever evaluated the effectiveness, safety and tolerability of imipenem/clavulanate versus meropenem/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/clavulanate versus meropenem/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 (8 versus 8) but more fluoroquinolone resistance (79.0% versus 48.9%, p<0.0001) and higher XDR-TB prevalence (67.9% versus 49.0%, 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) versus 85 (49-156) days, respectively. Statistically significant differences were observed on sputum smear and culture conversion rates (79.7% versus 94.8%, p=0.02 and 71.9% versus 94.8%, p<0.0001, respectively) and on success rates (59.7% versus 77.5%, 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. |