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Daily 300 mg dose of linezolid for the treatment of intractable multidrug-resistant and extensively drug-resistant tuberculosis

Authors
 Won-Jung Koh  ;  O. Jung Kwon  ;  Hyesun Gwak  ;  Joo Won Chung  ;  Sang-Nae Cho  ;  Woo Sung Kim  ;  Tae Sun Shim 
Citation
 JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, Vol.64(2) : 388-391, 2009 
Journal Title
 JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY 
ISSN
 0305-7453 
Issue Date
2009
MeSH
Acetamides/administration & dosage* ; Acetamides/adverse effects ; Acetamides/therapeutic use* ; Adult ; Antitubercular Agents/administration & dosage* ; Antitubercular Agents/adverse effects ; Antitubercular Agents/therapeutic use* ; Female ; Humans ; Linezolid ; Male ; Oxazolidinones/administration & dosage* ; Oxazolidinones/adverse effects ; Oxazolidinones/therapeutic use* ; Sputum/microbiology ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant/drug therapy*
Keywords
MDR-TB ; XDR-TB ; oxazolidinones ; efficacy ; tolerability
Abstract
BACKGROUND: Although previous studies have suggested that linezolid may be effective for treating multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB), the optimal dose of linezolid for intractable MDR/XDR-TB is not clear. METHODS: Twenty-four patients with intractable MDR/XDR-TB were treated with a daily 300 mg dose of linezolid as part of their anti-TB drug regimen. RESULTS: The patients were treated with linezolid for a median duration of 359 days [interquartile range (IQR) 268-443 days]. Seventeen (71%) patients received 300 mg of linezolid once daily from the beginning of treatment for a median duration of 289 days (IQR 233-405 days). Of these patients, four developed peripheral neuropathy, one of whom discontinued linezolid. In seven (29%) patients, 600 mg/day linezolid was administered initially for a median duration of 104 days (IQR 26-145 days) followed by 300 mg/day linezolid for a median duration of 348 days (IQR 298-427 days). In five of these seven patients, the reason for changing from 600 to 300 mg/day was due to side effects of 600 mg/day linezolid (peripheral neuropathy in four patients and leucopenia in one patient). After reducing the dose to 300 mg/day, linezolid could be continued in six of the seven patients. Negative sputum conversion was achieved in 22 (92%) patients after a median of 89 days from the start of linezolid treatment (IQR 48-160 days). CONCLUSIONS: A daily 300 mg dose of linezolid may be useful for increasing the chances of culture conversion in the treatment of patients with intractable MDR/XDR-TB and might have fewer side effects, especially neurotoxicity, compared with a daily 600 mg dose of linezolid therapy. The present results encourage further research into the use of a 300 mg dose of linezolid for MDR/XDR-TB patients
Files in This Item:
T200903519.pdf Download
DOI
10.1093/jac/dkp171
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실) > 1. Journal Papers
Yonsei Authors
Cho, Sang Nae(조상래)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105123
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