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Linezolid showed promise in extensively drug resistant TB
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LONDON — Treatment with linezolid in patients with extensively drug-resistant tuberculosis was safe and effective, with culture conversion occurring in all pulmonary cases at a median of 63 days, Shen-Jie Tang, MD, said during a presentation here.
“Using linezolid to treat extensively drug-resistant TB can significantly improve clinical symptoms, promote lesion absorption and cavity closure and accelerate sputum negative conversion,” Tang, of the Tuberculosis Diagnosis and Treatment Center of Shanghai Pulmonary Hospital in China, said during his presentation. “Therefore, it can help patients to improve life quality with mild adverse reaction but good drug tolerance.”
The study included 14 patients who initially received 600 mg IV linezolid (Zyvox, Pharmacia and Upjohn) twice per day for 1 to 6 weeks. The dosage was then reduced to 600 mg IV linezolid once per day. The minimum length of treatment was 2 months; maximum duration of treatment was 11 months; and the average length of treatment was 6 months.
On day 2 after treatment, all patients showed significant improvement in cough and sputum. Breath shortness, chest tightness and other symptoms also improved. After 6 months of linezolid treatment, 10 patients presented with cavity closure.
“Sputum smear negative conversion occurred in all pulmonary cases at a median of 64 days,” Tang said.
Two patients relapsed in both sputum and imaging after 4 months of not using linezolid. Six patients had nausea, vomiting or other gastrointestinal reactions, but these symptoms disappeared after reducing the linezolid dose, according to Tang. Three patients developed peripheral neuropathy, and two patients developed declining of eyesight. There were six cases of hematological adverse reactions.
Disclosure: Dr. Tang reports no relevant financial disclosures.
- For more information:Tang S. #0233. Presented at: 22nd European Congress of Clinical Microbiology and Infectious Diseases; March 31-April 3, 2012; London.