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

Simon Tiberi, Giovanni Sotgiu, L. D'Ambrosio, Rosella Centis, Marcos Abdo Arbex, Edith Alarcon Arrascue, Jan Willem C Alffenaar, Jose A. Caminero, Mina Gaga, Gina Gualano, Alena Skrahina, Ivan Solovic, Giorgia Sulis, Marina Tadolini, Valentina Alarcon Guizado, Saverio De Lorenzo, Aurora Jazmín Roby Arias, Anna Scardigli, Onno W. Akkerman, Alena Aleksa & 20 others Janina Artsukevich, Vera Auchynka, Eduardo Henrique Bonini, Félix Antonio Chong Marín, Lorena Collahuazo López, Gerard De Vries, Simone Dore, H. Kunst, Alberto Matteelli, Charalampos Moschos, Fabrizio Palmieri, Apostolos Papavasileiou, M. C. Payen, A. F. Piana, Antonio Spanevello, Dante Vargas Vasquez, Pietro Viggiani, Veronica White, Alimuddin Zumla, Giovanni Battista Migliori

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1758-1766
Number of pages9
JournalEuropean Respiratory Journal
Volume47
Issue number6
DOIs
Publication statusPublished - Jun 1 2016

Fingerprint

meropenem
Extensively Drug-Resistant Tuberculosis
Clavulanic Acid
Imipenem
Safety
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)
  • Pulmonary and Respiratory Medicine

Cite this

Comparison of effectiveness and safety of imipenem/clavulanate-versus meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB. / Tiberi, Simon; Sotgiu, Giovanni; D'Ambrosio, L.; Centis, Rosella; Arbex, Marcos Abdo; Arrascue, Edith Alarcon; Alffenaar, Jan Willem C; Caminero, Jose A.; Gaga, Mina; Gualano, Gina; Skrahina, Alena; Solovic, Ivan; Sulis, Giorgia; Tadolini, Marina; Guizado, Valentina Alarcon; De Lorenzo, Saverio; Arias, Aurora Jazmín Roby; Scardigli, Anna; Akkerman, Onno W.; Aleksa, Alena; Artsukevich, Janina; Auchynka, Vera; Bonini, Eduardo Henrique; Marín, Félix Antonio Chong; López, Lorena Collahuazo; De Vries, Gerard; Dore, Simone; Kunst, H.; Matteelli, Alberto; Moschos, Charalampos; Palmieri, Fabrizio; Papavasileiou, Apostolos; Payen, M. C.; Piana, A. F.; Spanevello, Antonio; Vasquez, Dante Vargas; Viggiani, Pietro; White, Veronica; Zumla, Alimuddin; Migliori, Giovanni Battista.

In: European Respiratory Journal, Vol. 47, No. 6, 01.06.2016, p. 1758-1766.

Research output: Contribution to journalArticle

Tiberi, S, Sotgiu, G, D'Ambrosio, L, Centis, R, Arbex, MA, Arrascue, EA, Alffenaar, JWC, Caminero, JA, Gaga, M, Gualano, G, Skrahina, A, Solovic, I, Sulis, G, Tadolini, M, Guizado, VA, De Lorenzo, S, Arias, AJR, Scardigli, A, Akkerman, OW, Aleksa, A, Artsukevich, J, Auchynka, V, Bonini, EH, Marín, FAC, López, LC, De Vries, G, Dore, S, Kunst, H, Matteelli, A, Moschos, C, Palmieri, F, Papavasileiou, A, Payen, MC, Piana, AF, Spanevello, A, Vasquez, DV, Viggiani, P, White, V, Zumla, A & Migliori, GB 2016, 'Comparison of effectiveness and safety of imipenem/clavulanate-versus meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB', European Respiratory Journal, vol. 47, no. 6, pp. 1758-1766. https://doi.org/10.1183/13993003.00214-2016
Tiberi, Simon ; Sotgiu, Giovanni ; D'Ambrosio, L. ; Centis, Rosella ; Arbex, Marcos Abdo ; Arrascue, Edith Alarcon ; Alffenaar, Jan Willem C ; Caminero, Jose A. ; Gaga, Mina ; Gualano, Gina ; Skrahina, Alena ; Solovic, Ivan ; Sulis, Giorgia ; Tadolini, Marina ; Guizado, Valentina Alarcon ; De Lorenzo, Saverio ; Arias, Aurora Jazmín Roby ; Scardigli, Anna ; Akkerman, Onno W. ; Aleksa, Alena ; Artsukevich, Janina ; Auchynka, Vera ; Bonini, Eduardo Henrique ; Marín, Félix Antonio Chong ; López, Lorena Collahuazo ; De Vries, Gerard ; Dore, Simone ; Kunst, H. ; Matteelli, Alberto ; Moschos, Charalampos ; Palmieri, Fabrizio ; Papavasileiou, Apostolos ; Payen, M. C. ; Piana, A. F. ; Spanevello, Antonio ; Vasquez, Dante Vargas ; Viggiani, Pietro ; White, Veronica ; Zumla, Alimuddin ; Migliori, Giovanni Battista. / Comparison of effectiveness and safety of imipenem/clavulanate-versus meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB. In: European Respiratory Journal. 2016 ; Vol. 47, No. 6. pp. 1758-1766.
@article{0d8e6e8938344d2ea9ec629fe19a03ed,
title = "Comparison of effectiveness and safety of imipenem/clavulanate-versus meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB",
abstract = "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.",
author = "Simon Tiberi and Giovanni Sotgiu and L. D'Ambrosio and Rosella Centis and Arbex, {Marcos Abdo} and Arrascue, {Edith Alarcon} and Alffenaar, {Jan Willem C} and Caminero, {Jose A.} and Mina Gaga and Gina Gualano and Alena Skrahina and Ivan Solovic and Giorgia Sulis and Marina Tadolini and Guizado, {Valentina Alarcon} and {De Lorenzo}, Saverio and Arias, {Aurora Jazm{\'i}n Roby} and Anna Scardigli and Akkerman, {Onno W.} and Alena Aleksa and Janina Artsukevich and Vera Auchynka and Bonini, {Eduardo Henrique} and Mar{\'i}n, {F{\'e}lix Antonio Chong} and L{\'o}pez, {Lorena Collahuazo} and {De Vries}, Gerard and Simone Dore and H. Kunst and Alberto Matteelli and Charalampos Moschos and Fabrizio Palmieri and Apostolos Papavasileiou and Payen, {M. C.} and Piana, {A. F.} and Antonio Spanevello and Vasquez, {Dante Vargas} and Pietro Viggiani and Veronica White and Alimuddin Zumla and Migliori, {Giovanni Battista}",
year = "2016",
month = "6",
day = "1",
doi = "10.1183/13993003.00214-2016",
language = "English",
volume = "47",
pages = "1758--1766",
journal = "European Journal of Respiratory Diseases",
issn = "0903-1936",
publisher = "European Respiratory Society",
number = "6",

}

TY - JOUR

T1 - Comparison of effectiveness and safety of imipenem/clavulanate-versus meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB

AU - Tiberi, Simon

AU - Sotgiu, Giovanni

AU - D'Ambrosio, L.

AU - Centis, Rosella

AU - Arbex, Marcos Abdo

AU - Arrascue, Edith Alarcon

AU - Alffenaar, Jan Willem C

AU - Caminero, Jose A.

AU - Gaga, Mina

AU - Gualano, Gina

AU - Skrahina, Alena

AU - Solovic, Ivan

AU - Sulis, Giorgia

AU - Tadolini, Marina

AU - Guizado, Valentina Alarcon

AU - De Lorenzo, Saverio

AU - Arias, Aurora Jazmín Roby

AU - Scardigli, Anna

AU - Akkerman, Onno W.

AU - Aleksa, Alena

AU - Artsukevich, Janina

AU - Auchynka, Vera

AU - Bonini, Eduardo Henrique

AU - Marín, Félix Antonio Chong

AU - López, Lorena Collahuazo

AU - De Vries, Gerard

AU - Dore, Simone

AU - Kunst, H.

AU - Matteelli, Alberto

AU - Moschos, Charalampos

AU - Palmieri, Fabrizio

AU - Papavasileiou, Apostolos

AU - Payen, M. C.

AU - Piana, A. F.

AU - Spanevello, Antonio

AU - Vasquez, Dante Vargas

AU - Viggiani, Pietro

AU - White, Veronica

AU - Zumla, Alimuddin

AU - Migliori, Giovanni Battista

PY - 2016/6/1

Y1 - 2016/6/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84973466840&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84973466840&partnerID=8YFLogxK

U2 - 10.1183/13993003.00214-2016

DO - 10.1183/13993003.00214-2016

M3 - Article

VL - 47

SP - 1758

EP - 1766

JO - European Journal of Respiratory Diseases

JF - European Journal of Respiratory Diseases

SN - 0903-1936

IS - 6

ER -