Effectiveness and safety of imipenem/clavulanate and linezolid to treat multidrug and extensively drug-resistant tuberculosis at a referral hospital in Brazil

Publication date: Available online 29 July 2016 Source:Revista Portuguesa de Pneumologia (English Edition) Author(s): M.A. Arbex, E.H. Bonini, G. Kawakame Pirolla, L. D’Ambrosio, R. Centis, G.B. Migliori Evidence on effectiveness, safety, and tolerability of imipenem/clavulanate (IC) and linezolid containing regimens to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) is scarce. The aim of this observational study is to evaluate the therapeutic contribution of IC and linezolid to manage MDR/XDR-TB cases at the reference centre of São Paulo state, Brazil. Twelve patients (9 males, 1 HIV positive in antiretroviral treatment, 4 MDR, 8 XDR) were treated with IC, 11 of them within linezolid-containing regimens. They all were previously treated with treatment failure, for a median (IQR, interquartile range) of 4.5 (2–6.5) times, having a severe resistance pattern (median number of resistances: 7 (5–8)) and being sputum smear and culture positive. IC and linezolid were prescribed at the dose of 1000mg/day and 600mg/day, respectively. The overall exposure was (median (IQR)) 419 (375.5–658) days for IC and 678 (392–720) days for linezolid. All of them converted their sputum (time to sputum conversion; 60 (37.5–90) days) and culture (75 (60–135) days), and 7 were cured while 5 are still on treatment with a gradually improving clinical picture. While no adverse events were reported for IC, 2 minor side effects, only, we...
Source: Revista Portuguesa de Pneumologia - Category: Respiratory Medicine Source Type: research