title: Outcomes of MDR/XDR-TB patients treated with linezolid: experience in Thailand.
abstract: BACKGROUND
  Multi-drug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) becomes an increasing problem in management. Linezolid has been off-label used in treatment of MDR/XDR-TB with major adverse effects.
  
  
  OBJECTIVE
  To study outcomes of MDR/XDR-TB patients treated with linezolid in Central Chest Institute of Thailand.
  
  
  METHODS
  MDR/XDR-TB patients treated with linezolid from 2009-2012 were retrospective analyzed
  
  
  RESULTS
  Seventeen from 24 cases had finished treatment. Linezolid, capreomycin, cycloserine, clofazimine, moxifloxacin, ethambutol, kanamycin, ethionamide, and PAS were used in 24, 21, 8, 7, 5, 5, 2, 2, and 2 cases respectively. Long-term injection of capreomycin was used in 14/17cases for an average of 14.7 months. Three point three drugs were used as an average. Average conversion time of smear and culture were 53.5 and 52.1 days respectively Treatment time averaged 19.1 months. Fifteen of 24 cases were cured, seven were still ongoing treatment, all had sputum culture conversion, and two cases failed. There was no relapse in 13 cases after a follow-up that averaged 10.6 months. Linezolid was stopped in five cases from peripheral or optic neuropathy. Capreomycin was stopped in four cases from vestibulotoxic and nephrotoxic.
  
  
  CONCLUSIONS
  Linezolid has good efficacy in treatment of MDR/XDR-TB with major adverse effect and should be used with caution. If capreomycin is susceptible or likely active, long-term injection should be considered when likely active drugs are not enough to strengthen the regimen.
authors.affiliation: Department of Respiratory Medicine, Central Chest Institute of Thailand, Nonthaburi, Thailand. chaiyos40@hotmail.com
authors.forename: Chaiyos
authors.initials: C
authors.lastname: Roongruangpitayakul
authors.affiliation: Department of Respiratory Medicine, Central Chest Institute of Thailand, Nonthaburi, Thailand.
authors.forename: Charoen
authors.initials: C
authors.lastname: Chuchottaworn
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002207:Capreomycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D056687:Off-Label Use; D023303:Oxazolidinones / Q000627:therapeutic use*; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D000995:Antitubercular Agents; D023303:Oxazolidinones; D002207:Capreomycin; D000069349:Linezolid