First series of patients with XDR and pre-XDR TB treated with regimens that included meropenen-clavulanate in Argentina

Arch Bronconeumol. 2015 Oct;51(10):e49-52. doi: 10.1016/j.arbres.2015.03.012. Epub 2015 May 27.
[Article in English, Spanish]

Abstract

XDR (extensively drug-resistant) and pre-XDR tuberculosis (TB) seriously compromise prognosis and treatment possibilities, and inevitably require the use of group V drugs (World Health Organization). The progress of all patients with XDR and pre-XDR TB seen in a specialized unit during 2012 and 2013 and treated with regimens that included at least 6 months of meropenem-clavulanate (MPC), capreomycin, moxifloxacin, linezolid, clofazimine, high-dose isoniazid, PAS, and bedaquiline in 1 case, were retrospectively analysed. Ten patients were treated, 9 with an extensive pattern of resistance to at least 6 drugs, and 1 because of adverse reactions and drug interactions leading to a similar situation. Eight of the 10 patients treated achieved bacteriological sputum conversion (2 consecutive negative monthly cultures) over a period of 2-7 months, while 2 died. No adverse reactions attributable to prolonged administration of MPC were observed.

Keywords: Carbapenems; Clavulanate; Clavulanato; Meropenem; TB-XDR; Tuberculosis; XDR-TB.

MeSH terms

  • Adult
  • Antitubercular Agents / classification
  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use*
  • Argentina / epidemiology
  • Clavulanic Acid / pharmacology
  • Clavulanic Acid / therapeutic use*
  • Drug Therapy, Combination
  • Extensively Drug-Resistant Tuberculosis / drug therapy*
  • Extensively Drug-Resistant Tuberculosis / epidemiology
  • Female
  • Humans
  • Male
  • Meropenem
  • Middle Aged
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / isolation & purification
  • Peru / ethnology
  • Retrospective Studies
  • Sputum / microbiology
  • Thienamycins / pharmacology
  • Thienamycins / therapeutic use*
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / epidemiology
  • Uruguay / ethnology
  • Young Adult

Substances

  • Antitubercular Agents
  • Thienamycins
  • Clavulanic Acid
  • Meropenem