Linezolid in the treatment of MDR-TB: a retrospective clinical study.
BACKGROUND
There is limited information on Chinese patients with multidrug-resistant tuberculosis (MDR-TB) treated with a linezolid-containing regimen.


OBJECTIVE
To examine treatment outcomes among MDR-TB patients who were treated with linezolid at the Shanghai Pulmonary Hospital,  China.


METHODS
We retrospectively reviewed 151 patients who were treated for MDR-TB from 2007 to 2010.


RESULTS
Eighteen MDR-TB patients, including 15 with extensively drug-resistant TB, received linezolid as part of their individualised treatment regimens. Patients had isolates resistant  to a median of 7 drugs (range 5-11). Of the 18 cases, 17 had cavitary changes and positive sputum smear microscopy results at the time of MDR-TB diagnosis. Culture conversion occurred in all cases at a median of 7 weeks. At data censure, 9 of the 18 patients had achieved treatment success.  Three continued to receive treatment. There were no deaths. Six patients had a poor outcome, including 1 default, 2 treatment failures and 3 relapses. Side effects occurred in 17 patients, including myelosuppression, neurotoxicity and gastrointestinal adverse events. Adverse events were managed  by combinations of temporary suspension of linezolid in 1 patient, dose adjustment in 17 patients and symptom management in 13 patients.


CONCLUSIONS
Linezolid may have efficacy in the treatment of MDR-TB, although treatment was complicated by adverse events.
Department of Clinical Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China. xuhongbin119@yahoo.cn
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D000081:Acetamides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002681:China; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D000069349:Linezolid; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D023303:Oxazolidinones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000382:microbiology; D055815:Young Adult
D000081:Acetamides; D000995:Antitubercular Agents; D023303:Oxazolidinones; D000069349:Linezolid