title: Linezolid: an effective, safe and cheap drug for patients failing multidrug-resistant tuberculosis treatment in India.
abstract: Linezolid is identified as an effective drug with which to treat patients failing multidrug-resistant (MDR)-tuberculosis (TB) treatment. However, cost and safety are the concerns. In India, the average price of a 600-mg pill of linezolid is less than one US dollar, much cheaper than most of the third-line drugs. A prospective study of 29 MDR-TB treatment failure patients (16 with laboratory-proven extensively drug-resistant (XDR)-TB and the remaining 13 with MDR-TB with resistance to any quinolone but sensitive to injectables) was carried out in Delhi, India. All patients received daily unsupervised therapy with linezolid, one injectable agent, one fluoroquinolone and two or more other drugs. Patients received a median of six anti-mycobacterial agents. Besides linezolid, capreomycin, moxifloxacin, levofloxacin and amoxycillin-clavulanic acid were used in 41.4%, 58.6%, 41.4%, and 79.3% of patients. Out of a total of 29 patients, 89.7% patients achieved sputum smear and culture conversion; 72.4% showed interim favourable outcome; 10.3% died, 6.8% failed and 10.3% patients defaulted. Linezolid had to be stopped in three (10.3%) patients due to adverse reactions. The outcome of treatment of 16 XDR-TB patients was comparable to the other 13 MDR-TB patients. Linezolid is an effective, cheap and relatively safe drug for patients failing MDR-TB treatment, including those with confirmed XDR-TB.
authors.affiliation: Dept of Tuberculosis and Chest Diseases, Lala Ram Sarup Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi 110030, India.
authors.forename: R
authors.initials: R
authors.lastname: Singla
authors.forename: J A
authors.initials: JA
authors.lastname: Caminero
authors.forename: A
authors.initials: A
authors.lastname: Jaiswal
authors.forename: N
authors.initials: N
authors.lastname: Singla
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: R K
authors.initials: RK
authors.lastname: Bali
authors.forename: D
authors.initials: D
authors.lastname: Behera
mesh_terms: D000081:Acetamides / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D016527:Drug Costs; D004359:Drug Therapy, Combination; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy* / Q000191:economics*; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D006801:Humans; D007194:India; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D023303:Oxazolidinones / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000995:Antitubercular Agents; D024841:Fluoroquinolones; D023303:Oxazolidinones; D000069349:Linezolid