Chest
Selected ReportsCase Series Report of a Linezolid-Containing Regimen for Extensively Drug-Resistant Tuberculosis*
Section snippets
Materials and Methods
Bellevue Hospital Center, which is a 768-bed New York City municipal hospital, is a referral center for difficult-to-treat patients with MDR-TB. Most patients are referred from the New York City Department of Health (NYCDOH) because of lack of response to treatment and/or drug intolerance. Starting in January 2000 and lasting until June 2007, in collaboration with the NYCDOH we began to use linezolid as a component of second-line therapy in patients for whom no adequate alternate treatment
Results
Seven patients (six female patients) were treated, and their demographic data are summarized in Table 1. The patients' ages ranged from 10 to 50 years at the time of the diagnosis. One patient was coinfected with HIV-1, and one patient was a liver transplant recipient.
The drugs added to the regimen to which patients had not responded are outlined in Table 1. In each case, we attempted to add a minimum of two drugs to that regimen, of which one was linezolid. The companion drug was tailored to
Discussion
Incomplete and inadequate treatment is the most important factor leading to the development of MDR-TB.10 MDR-TB, which is defined as resistance to at least isoniazid and rifampin, historically has had a poor prognosis despite treatment.11 Success rates as high as 90% have been reported with the use of fluoroquinolone agents.3 Resistance to fluoroquinolone agents ranges from 0.15% in the United States12 to 35% in the Philippines.13 We found resistance to a fluoroquinolone in 12% of MDR-TB
References (24)
- et al.
Comparative roles of levofloxacin and ofloxacin in the treatment of multidrug-resistant tuberculosis: preliminary results of a retrospective study from Hong Kong
Chest
(2003) - et al.
Efficacy and safety of linezolid in multidrug resistant tuberculosis (MDR-TB): a report of ten cases
J Infect
(2006) - et al.
Treatment of multidrug-resistant pulmonary tuberculosis with interferon-γ via aerosol
Lancet
(1997) - et al.
Multidrug-resistant tuberculosis: a menace that threatens to destabilize tuberculosis control
Chest
(2006) - et al.
Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin
N Engl J Med
(1993) - et al.
Outcome of MDR-TB patients, 1983-1993: prolonged survival with appropriate therapy
Am J Respir Crit Care Med
(1996) The global problem of multidrug-resistant tuberculosis: the genie is out of the bottle
JAMA
(2000)- et al.
In vitro activities of U-100592 and U-100766, novel oxazolidinone antibacterial agents
Antimicrob Agents Chemother
(1996) - et al.
Activities of several novel oxazolidinones against Mycobacterium tuberculosis in a murine model
Antimicrob Agents Chemother
(1999) - et al.
Linezolid for the treatment of multidrug-resistant tuberculosis
J Antimicrob Chemother
(2005)
Treatment of multidrug-resistant tuberculosis
N Engl J Med
Fluoroquinolone susceptibility among Mycobacterium tuberculosis isolates from the United States and Canada
Clin Infect Dis
Cited by (89)
Recommendations for treating children with drug-resistant tuberculosis
2016, Pharmacological ResearchTuberculosis
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionMultidrug-resistant Tuberculosis
2013, Medical Clinics of North AmericaCitation Excerpt :Linezolid, a member of the recently introduced class of oxazolidinone antibiotics, has been shown to have bacteriostatic activity against MTB in vitro.136 Although results in the murine model were not promising,137 a series of studies indicated some activity in humans infected with TB.138–140 In 2012, Lee and colleagues141 published the results of a randomized study of HIV-negative patients in South Korea with sputum culture–positive XDR-TB (including patients with genotypic/phenotypic resistance and treatment nonresponders with drug susceptibility).
The spread of drug-resistant tuberculosis in children: An Italian case series
2014, Epidemiology and Infection
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).