Clinical outcomes of linezolid treatment for extensively drug-resistant tuberculosis in Beijing, China: a hospital-based retrospective study

Abstract

Studies have shown that linezolid achieves good clinical outcomes against multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB). However, the efficacy of linezolid for individual TB patients and its precise contribution to combination regimens remain unclear for Chinese patients. This study examined the clinical outcomes and safety of linezolid in adults with XDR pulmonary TB at the Chinese PLA 309 hospital. Sixteen XDR-TB patients received linezolid (600 mg daily) in addition to vitamin B6 (50-100 mg daily) as part of their individualized treatment regimens. Of the 16 patients, 14 had received previous treatment for tuberculosis. Sputum samples for all patients showed high colony-forming unit counts when tested by a real-time polymerase chain reaction (PCR). In addition, a high proportion of patients had cavitary lesions in the lungs. Eleven of the 16 patients (68.75%) had successfully completed therapy with documented negative quantitative PCR (qPCR) data and cultures at follow-up (mean = 12 months). Three patients (18.75%) are still receiving treatment, and all 3 have shown clinical and radiographic improvement. Linezolid was discontinued for 2 patients with persistent positive qPCR data and cultures because they developed severe, intractable diarrhea and nausea shortly after beginning treatment. Data indicated that linezolid was a well-tolerated and efficient treatment for XDB-TB in of Chinese patients.