title: First series of patients with XDR and pre-XDR TB treated with regimens that included meropenen-clavulanate in Argentina.
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.
authors.affiliation: Instituto Prof. Dr. Raúl Vaccarezza, Hospital de Infecciosas Dr. F.J. Muñiz, Buenos Aires, Argentina. Electronic address: djpalmero@intramed.net.
authors.forename: Domingo
authors.initials: D
authors.lastname: Palmero
authors.affiliation: Instituto Prof. Dr. Raúl Vaccarezza, Hospital de Infecciosas Dr. F.J. Muñiz, Buenos Aires, Argentina.
authors.forename: Pablo
authors.initials: P
authors.lastname: González Montaner
authors.affiliation: Instituto Prof. Dr. Raúl Vaccarezza, Hospital de Infecciosas Dr. F.J. Muñiz, Buenos Aires, Argentina.
authors.forename: Mónica
authors.initials: M
authors.lastname: Cufré
authors.affiliation: Instituto Prof. Dr. Raúl Vaccarezza, Hospital de Infecciosas Dr. F.J. Muñiz, Buenos Aires, Argentina.
authors.forename: Ana
authors.initials: A
authors.lastname: García
authors.affiliation: Instituto Prof. Dr. Raúl Vaccarezza, Hospital de Infecciosas Dr. F.J. Muñiz, Buenos Aires, Argentina.
authors.forename: Marisa
authors.initials: M
authors.lastname: Vescovo
authors.affiliation: Instituto Prof. Dr. Raúl Vaccarezza, Hospital de Infecciosas Dr. F.J. Muñiz, Buenos Aires, Argentina.
authors.forename: Susana
authors.initials: S
authors.lastname: Poggi
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use*; D001118:Argentina / Q000453:epidemiology; D019818:Clavulanic Acid / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D010568:Peru / Q000208:ethnology; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D013845:Thienamycins / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology; D014583:Uruguay / Q000208:ethnology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D013845:Thienamycins; D019818:Clavulanic Acid; D000077731:Meropenem
keywords: Carbapenems; Clavulanate; Clavulanato; Meropenem; TB-XDR; Tuberculosis; XDR-TB