Linezolid-Associated Neurologic Adverse Events in Patients with Multidrug-Resistant Tuberculosis, France.

Abstract

Linezolid is one of the most effective drugs for treating multidrug-resistant tuberculosis (MDR TB), but adverse effects remain problematic. We evaluated 57 MDR TB patients who had received >1 dose of linezolid during 2011-2016. Overall, patients received 600 mg/day of linezolid for a median of 13 months. In 33 (58%) patients, neurologic or ophthalmologic signs developed, and 18 (32%) had confirmed peripheral neuropathy, which for 78% was irreversible at 12 months after the end of TB treatment despite linezolid withdrawal. Among the 19 patients who underwent ophthalmologic evaluation, 14 patients had optic neuropathy that fully reversed for 2. A total of 16 (33%) of 49 patients had a linezolid trough concentration >2 mg/L, and among these, 14 (88%) experienced adverse effects. No significant association was found between trough concentration and neurologic toxicity. These findings suggest the need to closely monitor patients for neurologic signs and discuss optimal duration of linezolid treatment.

• Authors: Marie Jaspard, Nathalie Butel, Najoua El Helali, Dhiba Marigot-Outtandy, Helene Guillot, Gilles Peytavin, Nicolas Veziris, Bahram Bodaghi, Philippe Flandre, Gregoire Petitjean, Eric Caumes, Valerie Pourcher
• Journal: Emerging infectious diseases (Emerg Infect Dis) Vol. 26 Issue 8 Pg. 1792-1800 (08 2020) ISSN: 1080-6059 [Electronic] United States
• PMID: 32687026 (Publication Type: Journal Article)

Chemical References

• Antitubercular Agents
• Linezolid

Topics

• Antitubercular Agents (adverse effects)
• France (epidemiology)
• Humans
• Linezolid (adverse effects)
• Treatment Outcome
• Tuberculosis, Multidrug-Resistant (drug therapy, epidemiology)