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Infection. 2014 Aug;42(4):705-11. doi: 10.1007/s15010-014-0632-2. Epub 2014 Jun 6.

Linezolid in the treatment of extensively drug-resistant tuberculosis.

Author information

1
Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, No. 97, Machang, Tongzhou District, Beijing, 101149, People's Republic of China.

Abstract

PURPOSE:

To investigate the linezolid (LZD) treatment outcome and correlation between in vitro susceptibility to LZD and clinical outcome.

METHODS:

We retrospectively reviewed records of tuberculosis (TB) patients who received treatment with linezolid between March 2012 and February 2013.

RESULTS:

A total of 43 extensively drug-resistant (XDR) TB patients identified by drug susceptibility testing were enrolled in this study, including 15 (34.9 %) received LZD as part of individualized treatment regimens. Among the 43 XDR TB patients, 15 patients (34.9 %) obtained favorable clinical outcome, including 9 (60.0 %) from LZD group and 6 (21.4 %) from control group without LZD. Statistical analysis revealed that the percentage of favorable outcomes of LZD group was significantly higher than that of control group (P = 0.011). Furthermore, we analyzed the LZD minimum inhibitory concentrations of Mycobacterium tuberculosis (MTB) isolates from patients in LZD group and identified 4 (26.7 %) resistant to LZD. All of the patients with LZD resistance harbored adverse clinical outcome, while most of the patients infected with LZD sensitive MTB harbored favorable clinical outcome (81.8 %, 9/11). Statistical analysis revealed that the percentage of favorable outcome among the patients with LZD resistance was statistically lower than that among the LZD susceptible group (P = 0.011).

CONCLUSION:

This study demonstrates that linezolid has efficacy against XDR pulmonary TB patients, even in shorter duration of administration. The XDR TB patients infected with LZD-resistant isolates were more likely to obtain the adverse clinical outcome under the treatment of regimen containing LZD.

PMID:
24902521
DOI:
10.1007/s15010-014-0632-2
[Indexed for MEDLINE]

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