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
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