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Linezolid in the treatment of extensively drug-resistant tuberculosis

  • Clinical and Epidemiological Study
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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.

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Acknowledgments

The study was supported by National Key Project (2013003ZX003).

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  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

    L. Zhang, X. Yu, Y. Wang, M. Gao & H. Huang

  2. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Chang Bai Road, Changping District, Beijing, 102206, People’s Republic of China

    Y. Pang & Y. Zhao

Authors
  1. L. Zhang
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  2. Y. Pang
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  3. X. Yu
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  4. Y. Wang
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  5. M. Gao
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  6. H. Huang
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  7. Y. Zhao
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Corresponding authors

Correspondence to M. Gao, H. Huang or Y. Zhao.

Additional information

Liqun Zhang, Yu Pang and Xia Yu have contributed equally to this study.

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Zhang, L., Pang, Y., Yu, X. et al. Linezolid in the treatment of extensively drug-resistant tuberculosis. Infection 42, 705–711 (2014). https://doi.org/10.1007/s15010-014-0632-2

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  • DOI: https://doi.org/10.1007/s15010-014-0632-2

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