2421. Tedizolid Is Well-Tolerated Among Patients Receiving Prolonged Treatment Courses

Abstract

BackgroundTedizolid (TED) is a newly-approved oxazolidinone antibiotic that may be better tolerated than linezolid; however, real-world clinical data are limited, particularly among patients receiving prolonged treatment courses. Our objective was to review our clinical experience with TED and describe rates of adverse events.MethodsRetrospective review of patients receiving >24 hours of TED between June 2015 and April 2018. Adverse events were determined according to standard definitions.Results55 patients receiving 60 different TED treatment courses were included. The median duration of treatment was 7 days (range: 2–141 days); 42% and 16% of patients received courses ≥10 and ≥30 days, respectively. 44% of patients were male, the median age was 58 (20–88), and 35% were immunosuppressed, including 22% of patients who received a solid-organ transplant. Indications for TED were skin/soft-tissue infections (n = 23), bacteremia (n = 10), osteomyelitis/septic arthritis (n = 7), endocarditis/endovascular infection (n = 5), pneumonia (n = 4), M. abscessus treatment (n = 3), intra-abdominal infection (n = 2) and urinary tract infection (n = 1). 60% of patients failed alternative therapies prior to TED treatment. Specifically, 31% of patients had documented adverse events to linezolid (n = 8), daptomycin (n = 3), vancomycin (n = 3), quinupristin/dalfopristin, televancin, or tigecycline (n = 1 each). At initiation of TED, the median platelet (PLT) count (per 1000 cells/L) was 205 (range: 16–674); 20% had baseline thrombocytopenia (PLT <100). Overall, 11% of patients experienced an adverse event or intolerability leading to TED discontinuation, including 3 patients with thrombocytopenia (>50% decrease in PLT) and 1 patient each with a rash, vomiting, and confusion. 67% of patients with thrombocytopenia were previously intolerant of linezolid. No patients experienced lactic acidosis, peripheral neuropathy, or neutropenia. Notably, TED was well tolerated for treatment courses up to 141 days and among 2 patients with repeated, prolonged courses.ConclusionAmong acutely and chronically-ill patients, TED was well-tolerated. This includes patients who received long-term treatment with TED, and those who were intolerant of alternative antibiotics.Disclosures R. K. Shields, Allergan: Grant Investigator, Research grant. Pfizer: Consultant and Scientific Advisor, Speaker honorarium. Shionogi: Scientific Advisor, Consulting fee. Roche: Grant Investigator, Research grant. Venatorx: Grant Investigator, Research grant. Medicines Company: Grant Investigator and Scientific Advisor, Consulting fee and Research grant. Accelerate Diagnostics: Scientific Advisor, Consulting fee.