Outcomes of MDR/XDR-TB Patients Treated with
Linezolid: Experience in Thailand
Chaiyos Roongruangpitayakul MD*,
Charoen Chuchottaworn MD*
Affiliation :
* Department of Respiratory Medicine, Central Chest Institute of Thailand, Nonthaburi, Thailand
Background : Multi-drug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) becomes an increasing problem
in management. Linezolid has been off-label used in treatment of MDR/XDR-TB with major adverse effects.
Objective : To study outcomes of MDR/XDR-TB patients treated with linezolid in Central Chest Institute of Thailand.
Material and Method: MDR/XDR-TB patients treated with linezolid from 2009-2012 were retrospective analyzed.
Results : Seventeen from 24 cases had finished treatment. Linezolid, capreomycin, cycloserine, clofazimine, moxifloxacin,
ethambutol, kanamycin, ethionamide, and PAS were used in 24, 21, 8, 7, 5, 5, 2, 2, and 2 cases respectively. Long-term
injection of capreomycin was used in 14/17cases for an average of 14.7 months. Three point three drugs were used as an
average. Average conversion time of smear and culture were 53.5 and 52.1 days respectively. Treatment time averaged
19.1 months. Fifteen of 24 cases were cured, seven were still ongoing treatment, all had sputum culture conversion, and
two cases failed. There was no relapse in 13 cases after a follow-up that averaged 10.6 months. Linezolid was stopped in
five cases from peripheral or optic neuropathy. Capreomycin was stopped in four cases from vestibulotoxic and nephrotoxic.
Conclusion : Linezolid has good efficacy in treatment of MDR/XDR-TB with major adverse effect and should be used with
caution. If capreomycin is susceptible or likely active, long-term injection should be considered when likely active drugs
are not enough to strengthen the regimen.
Keywords : Capreomycin, Drug-resistant, Linezolid, Treatment, Tuberculosis
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