TY - JOUR T1 - Safety, tolerability and efficacy of linezolid for the treatment of M/XDR-TB: A systematic review and meta-analysis JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p4399 AU - Giovanni Sotgiu AU - Holly Anger AU - Rosella Centis AU - Lia D'Ambrsoio AU - Saverio De Lorenzo AU - Christoph Lange AU - Gisela F. Schecter AU - Tae Sun Shim AU - Alena Skrahina AU - Miguel Villar AU - Elisabetta Zampogna AU - Jean-Pierre Zellweger AU - Giovanni Battista Migliori Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p4399.abstract N2 - Background: ≥40% of M/XDR-TB cases treated off-label with a linezolid-containing anti-TB regimen experienced adverse events (AE).Aim: We performed a systematic review/meta-analysis according to PRISMA guidelines on safety, tolerability and efficacy of linezolid in M/XDR-TB patients.Methods: 2 reviewers independently analyzed 9 articles using an electronic form. Original data were provided by the senior Authors of 5/9 studies.Results: Out of 130 cases 92 (70.8%) and 38 (29.2%) were affected by MDR- and XDR-TB, respectively. 51/75 (68%) were born in Europe (35/51, 68.6%, in FSU countries), 14/75 (18.7%) in Asia and 7/75 (9.3%) in Africa; 78/130 (60%) were males, 14/116 (12.1%) HIV+ and 59/82 (72%) migrants. 83/127 (65.4%) have been previously treated, 94/118 (79.7%) were smear-positive and 22/116 (19%) underwent surgery. Median (IQR) hospital stay was 144.5 (66-194) days. Overall, 94/127 (74%) achieved treatment success, 16/127 (12.6%) died, 1/127 (0.8%) failed, 4/127 (3.2%) defaulted, 1/127 (0.8%) was transferred-out, 11/127 (8.7%) being still on treatment. 62/121 (51.2) experienced AE, 41/130 (31.5%) requiring linezolid interruption (36/120, 30%, episodes of anaemia, 26/120, 21.7%, peripheral neuropathy, 15/120, 12.5%, thrombocytopenia, 16/120, 13.3%, gastro-intestinal disorders, 8/120, 6.7%, leucopoenia). 41/62 (66.1%) cases had reversible AE. Patients treated with 1,200 mg/day (78/130, 60%) suffered significantly more AE than those treated with 600 mg/day (50/130, 38.5%): 44/78, 56.4%, vs. 16/50, 32%, respectively (P=0.008).Conclusion: The toxicity of linezolid is dose-dependent and the drug should be used only for the most severe, otherwise untreatable cases. ER -