Produção Nacional
Revisado por pares
Effectiveness and safety of imipenem/clavulanate and linezolid to treat multidrug and extensively drug-resistant tuberculosis at a referral hospital in Brazil
2016; Elsevier BV; Volume: 22; Issue: 6 Linguagem: Inglês
10.1016/j.rppnen.2016.06.006
ISSN2173-5115
AutoresMarcos Abdo Arbex, Eduardo Henrique Bonini, G. Kawakame Pirolla, Lia D’Ambrosio, Rosella Centis, Giovanni Battista Migliori,
Tópico(s)Pneumocystis jirovecii pneumonia detection and treatment
ResumoEvidence 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 1000 mg/day and 600 mg/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, were attributed to linezolid (17%); in both cases the drug was re-started without further problems. Our study suggests that IC and linezolid-containing regimens can be used safely and with satisfactory outcomes in reference centres to treat MDR/XDR-TB patients.
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