Linezolid in the treatment of MDR-TB: a retrospective clinical study

Abstract

There is limited information on Chinese patients with multidrug-resistant tuberculosis (MDR-TB) treated with a linezolid-containing regimen. To examine treatment outcomes among MDR-TB patients who were treated with linezolid at the Shanghai Pulmonary Hospital, China. We retrospectively reviewed 151 patients who were treated for MDR-TB from 2007 to 2010. 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. Linezolid may have efficacy in the treatment of MDR-TB, although treatment was complicated by adverse events.