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• W2001530822 abstract "Despite moderate early bactericidal activity 1 Dietze R Hadad DJ McGee B et al. Early and extended early bactericidal activity of linezolid in pulmonary tuberculosis. Am J Respir Crit Care Med. 2008; 178: 1180-1185 Crossref PubMed Scopus (130) Google Scholar and restricted activity in the murine model, 2 Williams KN Stover CK Zhu T et al. Promising antituberculosis activity of the oxazolidinone PNU-100480 relative to that of linezolid in a murine model. Antimicrob Agents Chemother. 2009; 53: 1314-1319 Crossref PubMed Scopus (179) Google Scholar linezolid has been used to treat fluoroquinolone-resistant multidrug-resistant (MDR) tuberculosis and extensively drug-resistant (XDR) tuberculosis with clinical improvement. 3 Schecter GF Scott C True L Raftery A Flood J Mase S Linezolid in the treatment of multidrug-resistant tuberculosis. Clin Infect Dis. 2010; 50: 49-55 Crossref PubMed Scopus (146) Google Scholar , 4 Migliori GB Eker B Richardson MD et al. A retrospective TBNET assessment of linezolid safety, tolerability and efficacy in multidrug-resistant tuberculosis. Eur Respir J. 2009; 34: 387-393 Crossref PubMed Scopus (165) Google Scholar , 5 Koh W-J Kwon OJ Gwak H et al. Daily 300 mg dose of linezolid for the treatment of intractable multidrug-resistant and extensively drug-resistant tuberculosis. J Antimicrob Chemother. 2009; 64: 388-391 Crossref PubMed Scopus (86) Google Scholar , 6 Yew WW Chau CH Wen KH Linezolid in the treatment of ‘difficult’ multidrug-resistant tuberculosis. Int J Tuberc Lung Dis. 2008; 12: 345-346 PubMed Google Scholar Singla and colleagues 7 Singla R Caminero JA Jaiswal A et al. Linezolid, an effective, safe and cheap drug in MDR-TB treatment failure patients in India. Eur Respir J. 2012; 39: 956-962 Crossref PubMed Scopus (56) Google Scholar reported unsupervised use of generic linezolid at 600 mg once or twice daily in 16 patients with XDR tuberculosis and 13 fluoroquinolone-resistant patients with MDR tuberculosis. With 90% of patients achieving sputum smear and culture conversion, and 72% attaining interim favourable outcome, the investigators concluded that linezolid was effective, cheap, and fairly safe for patients in India who had MDR-tuberculosis treatment failure. Although the reported rates of favourable outcome and major adverse events were comparable to those in two moderately large case series, 3 Schecter GF Scott C True L Raftery A Flood J Mase S Linezolid in the treatment of multidrug-resistant tuberculosis. Clin Infect Dis. 2010; 50: 49-55 Crossref PubMed Scopus (146) Google Scholar , 4 Migliori GB Eker B Richardson MD et al. A retrospective TBNET assessment of linezolid safety, tolerability and efficacy in multidrug-resistant tuberculosis. Eur Respir J. 2009; 34: 387-393 Crossref PubMed Scopus (165) Google Scholar the study should be interpreted with caution. The findings were uncontrolled, based on a small selected sample, interim with no definitive treatment outcomes, unsubstantiated by pharmacokinetic data, assessed without drug susceptibility testing of linezolid, and possibly confounded by linezolid of uncertain quality and unascertainable treatment adherence. Linezolid-resistant isolates of Mycobacterium tuberculosis have already emerged, 8 Huang T-S Liu Y-C Sy C-L Chen Y-S Tu H-Z Chen B-C In vitro activities of linezolid against clinical isolates of Mycobacterium tuberculosis complex isolated in Taiwan over 10 years. Antimicrob Agents Chemother. 2008; 52: 2226-2227 Crossref PubMed Scopus (42) Google Scholar and the optimum linezolid dosage to treat MDR tuberculosis is unknown. With no controlled trials, to base therapy on anecdotal treatment successes with linezolid could be dangerous. Linezolid for multidrug-resistant tuberculosisIn their Comment in The Lancet Infectious Diseases, Kwok-Chiu Chang and colleagues1 concluded that expansion of access to linezolid for complicated cases of drug-resistant tuberculosis risks the loss of a potentially useful drug and could promote the emergence and spread of drug-resistant tuberculosis in the community. The rationale behind this idea seems to be the scarcity of controlled clinical trials and, in particular, data for optimum linezolid dose. Although we agree that the evidence base is small, our recent systematic review2 suggests that good outcomes can be achieved with linezolid among patients who would otherwise have very poor outcomes and high mortality. Full-Text PDF Linezolid for multidrug-resistant tuberculosis – Authors' replyIn our recent Comment,1 we concluded that a “non-expensive and non-proprietary source of linezolid is insufficient to tackle the evolving global crisis of drug-resistant tuberculosis”. This conclusion was not simply based on “scarcity of controlled clinical trials and, in particular, data for optimum linezolid dose”, as suggested by Helen Cox and colleagues. Rather, the rationale was the difficult lessons that mankind has learned since anti-tuberculosis chemotherapy became available, especially in view of the wide social divide between rich and poor people, both within and between countries. Full-Text PDF" @default.
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• W2001530822 title "Linezolid for multidrug-resistant tuberculosis" @default.
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• W2001530822 doi "https://doi.org/10.1016/s1473-3099(12)70137-8" @default.
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