Abstract
Linezolid's (L) long-term use in the treatment of MDR-TB and NTM may be limited by its serious adverse reactions. Aim of this study was to evaluate the efficacy and tolerability of a daily dose of 600 mgr of L in combination with other drugs against mycobacteria, in patients with culture proven MDR-TB and NTM disease.
Method: Between Sept 2008 and Jan 2011 in our TB Unit/Outpatient Clinic we followed 34 MDR-TB + XDR-TB and 18 NTM pts. Of them, 19 pts (2 XDR, 4 NTM), all HIV (–), had been treated with L which was added to regimens for 4-24 months (median 17). Sputum cultures, blood count/chemistry, ophalmologic and neurologic examination were undertaken on a regular basis.
Results: 16 pts completed treatment and were cured. Cultures became negative in all pts in an average of 14–32 weeks. One died after 5 months of treatment due to chronic respiratory failure and progressive M. avium disease, 2 discontinued (no adherence) after 5 and 7 months. 3 of 16 pts experienced adverse events, which led to withdrawal of L in all 3. 2 pts developed bone marrow depression and one optic neuropathy. Blood transfusions were given to both pts and bone marrow function normalized after cessation of L.
Conclusion: Linezolid seems highly effective in combination treatment of MDR-TB, XDR-TB and NTM disease. The majority of patients on L had positive treatment outcomes. All pts under L treatment should be monitored closely for presence of serious adverse reactions.
- © 2011 ERS