Comparison of effectiveness and safety of imipenem/clavulanate- versus meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB

被引：23

作者：

Tiberi, Simon ^{[1
]}

Sotgiu, Giovanni ^{[2
]}

D'Ambrosio, Lia ^{[3
,4
]}

Centis, Rosella ^{[3
]}

Arbex, Marcos Abdo ^{[5
,6
]}

Arrascue, Edith Alarcon ^{[7
,8
]}

Alffenaar, Jan Willem ^{[9
]}

Caminero, Jose A. ^{[8
,10
]}

Gaga, Mina ^{[11
]}

Gualano, Gina ^{[12
]}

Skrahina, Alena ^{[13
]}

Solovic, Ivan ^{[14
]}

Sulis, Giorgia ^{[15
]}

Tadolini, Marina ^{[16
,17
]}

Alarcon Guizado, Valentina ^{[18
]}

De Lorenzo, Saverio ^{[19
]}

Roby Arias, Aurora Jazmin ^{[20
]}

Scardigli, Anna

Akkerman, Onno W. ^{[21
]}

Aleksa, Alena ^{[22
]}

Artsukevich, Janina ^{[22
]}

Auchynka, Vera ^{[13
]}

Bonini, Eduardo Henrique ^{[5
,6
]}

Chong Marin, Felix Antonio

Collahuazo Lopez, Lorena ^{[20
]}

de Vries, Gerard ^{[23
]}

Dore, Simone ^{[2
]}

Kunst, Heinke ^{[24
]}

Matteelli, Alberto

Moschos, Charalampos ^{[11
]}

Palmieri, Fabrizio ^{[12
]}

Papavasileiou, Apostolos ^{[11
]}

Payen, Marie-Christine ^{[25
]}

Piana, Andrea ^{[2
]}

Spanevello, Antonio ^{[26
,27
]}

Vargas Vasquez, Dante ^{[28
]}

Viggiani, Pietro ^{[19
]}

White, Veronica ^{[29
]}

Zumla, Alimuddin ^{[30
]}

Migliori, Giovanni Battista ^{[3
]}

机构：

[1] Barts Healthcare NHS Trust, Div Infect, London, England

[2] Univ Sassari Res, AOU Sassari, Dept Biomed Sci, Med Educ & Profess Dev Unit,Clin Epidemiol & Med, Sassari, Italy

[3] Fdn S Maugeri, WHO Collaborating Ctr TB & Lung Dis, Tradate, Italy

[4] Publ Hlth Consulting Grp, Lugano, Switzerland

[5] Univ Ctr Araraquara, Sao Paulo, Brazil

[6] Sao Paulo State Secretary Hlth, Hosp Nestor Goulart Reis, Sao Paulo, Brazil

[7] Int Union TB & Lung Dis Union, Lima, Peru

[8] Int Union TB & Lung Dis Union, TB Div, MDR TB Unit, Paris, France

[9] Univ Groningen, Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, Groningen, Netherlands

[10] Hosp Gen Gran Canaria Dr Negrin, Pneumol Dept, Las Palmas Gran Canaria, Spain

[11] Natl Referral Ctr Mycobacteria, Athens Chest Hosp Sotira, MDR TB Unit, Athens, Greece

[12] Natl Inst Infect Dis L Spallanzani, Resp Infect Dis Unit, Rome, Italy

[13] Republ Res & Pract Ctr Pulmonol & TB, Minsk, BELARUS

[14] Catholic Univ Ruzomberok, Natl Inst TB Lung Dis & Thorac Surg Vysne Hagy, Ruzomberok, Slovakia

[15] Univ Brescia, WHO Collaborating Ctr TB HIV Coinfect & TB Elimi, Univ Dept Infect & Trop Dis, Brescia, Italy

[16] Brescia Spedali Civili Gen Hosp, Brescia, Italy

[17] Univ Bologna, Alma Mater Studiorum, Dept Med & Surg Sci, Unit Infect Dis, Bologna, Italy

[18] Minist Hlth, Natl TB Control Programme, Lima, Peru

[19] Reference Hosp MDR & HIV TB, AOVV E Morelli Hosp, Sondalo, Italy

[20] Pulmonol Hosp Alfredo J Valenzuela, Natl TB Control Programme, Guayaquil, Ecuador

[21] Univ Groningen, Univ Med Ctr Groningen, TB Ctr Beatrixoord, Dept Pulm Dis & TB, Groningen, Netherlands

[22] Grodno State Med Univ, Educ Inst, Grodno, BELARUS

[23] KNCV TB Fdn, The Hague, Netherlands

[24] Queen Mary Univ, Dept Resp Med, London, England

[25] Univ Libre Bruxelles, CHU St Pierre, Div Infect Dis, Brussels, Belgium

[26] IRCCS, Fdn Maugeri, Pneumol Unit, Tradate, Italy

[27] Univ Insubria, Dept Clin & Expt Med, Varese, Italy

[28] Minist Hlth, Natl Hosp Hipolito Unanue, Inst Publ Hlth, Lima, Peru

[29] UCL, Div Infect & Immun, London, England

[30] UCL Hosp NHS Fdn Trust, NIHR Biomed Res Ctr, London, England

来源：

EUROPEAN RESPIRATORY JOURNAL | 2016年 / 47卷 / 06期

关键词：

DRUG-RESISTANT TUBERCULOSIS; MULTIDRUG-RESISTANT; MEROPENEM-CLAVULANATE; LINEZOLID SAFETY; EFFICACY; BEDAQUILINE; TOLERABILITY; DELAMANID; ELIMINATION; MANAGEMENT;

D O I：

10.1183/13993003.00214-2016

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

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.

引用

页码：1758 / 1766

页数：9

共 13 条

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Tiberi, Simon
Payen, Marie-Christine
Sotgiu, Giovanni
D'Ambrosio, Lia
Guizado, Valentina Alarcon
Alffenaar, Jan Willem
Arbex, Marcos Abdo
Caminero, Jose A.
Centis, Rosella
De Lorenzo, Saverio
Gaga, Mina
Gualano, Gina
Roby Arias, Aurora Jazmin
Scardigli, Anna
Skrahina, Alena
Solovic, Ivan
Sulis, Giorgia
Tadolini, Marina
Akkerman, Onno W.
Arrascue, Edith Alarcon
Aleska, Alena
Avchinko, Vera
Bonini, Eduardo Henrique
Chong Marin, Felix Antonio
Lopez, Lorena Collahuazo
de Vries, Gerard
Dore, Simone
Kunst, Heinke
Matteelli, Alberto
Moschos, Charalampos
Palmieri, Fabrizio
Papavasileiou, Apostolos
Spanevello, Antonio
Vasquez, Dante Vargas
Viggiani, Pietro
White, Veronica
Zumla, Alimuddin
Migliori, Giovanni Battista
EUROPEAN RESPIRATORY JOURNAL, 2016, 47 (04) : 1235 - 1243
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D'Ambrosio, Lia
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Caminero, Jose A.
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[4] Effectiveness and safety of bedaquiline-containing regimens in the treatment of MDR- and XDR-TB: a multicentre study
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Gualano, Gina
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Moschos, Charalampos
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EUROPEAN RESPIRATORY JOURNAL, 2016, 48
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