Clinical outcomes of linezolid-related adverse events in patients with multidrug-resistant TB

<sec><title>BACKGROUND</title>Linezolid is effective against multidrug-resistant TB (MDR-TB) but is frequently associated with adverse events that limit long-term use. However, data on the clinical outcomes following linezolid-related adverse events among patients with MDR-TB remain limited.</sec><sec><title>METHODS</title>This retrospective multicentre study in Japan comprised 81 patients with MDR-TB who developed linezolid-related adverse events during treatment with an initial standard dose of linezolid (600 mg).</sec><sec><title>RESULTS</title>Peripheral neuropathy, hematotoxicity, and optic neuropathy were the most frequent adverse events. Most patients with hematotoxicity improved with linezolid discontinuation or dose reduction. However, 20 of 44 patients (45%) with peripheral neuropathy and 2 out of 11 patients (18%) with optic neuropathy did not improve after 1 year of discontinuation. A longer duration from the onset of neuropathy to discontinuation and higher total dosage from the onset to discontinuation were risk factors for both residual peripheral neuropathy and optic neuropathy. Among the patients who discontinued linezolid owing to hematotoxicity, the recurrence rate was 19% (3/16) in those who re-administered linezolid at a low dose (300 mg).</sec><sec><title>CONCLUSION</title>If peripheral neuropathy or optic neuropathy occurs, continuous administration of linezolid may lead to long-term residual neuropathies. Re-administration of low-dose linezolid may be considered in cases of hematotoxicity.</sec>.

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Journal
The International Journal of Tuberculosis and Lung Disease
Published
2025-09-26
DOI
https://doi.org/10.5588/ijtld.25.0125
Primary Topic
Tuberculosis Research and Epidemiology
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article
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article

Clinical outcomes of linezolid-related adverse events in patients with multidrug-resistant TB

Keisuke Kamada, Kentaro Wakamatsu, Satoshi Mitarai, Akiko Takaki et al.
The International Journal of Tuberculosis and Lung Disease
Tuberculosis Research and Epidemiology
article

Clinical outcomes of linezolid-related adverse events in patients with multidrug-resistant TB

Keisuke Kamada, Kentaro Wakamatsu, Satoshi Mitarai, Akiko Takaki, Yoshifusa Koreeda, K Tsuyuguchi, Takashi Yoshiyama, Katsuhiro Kuwabara, Shunsuke Tamaki, Takashi Kato, Masaru Amishima, Yuta Hayashi, Eri Hagiwara, Hidenari Nagai, Tatsuya Kodama, Yuka Sasaki, Seiya Kato, M. Okumura, Akira Yamane
article en

Abstract

<sec><title>BACKGROUND</title>Linezolid is effective against multidrug-resistant TB (MDR-TB) but is frequently associated with adverse events that limit long-term use. However, data on the clinical outcomes following linezolid-related adverse events among patients with MDR-TB remain limited.</sec><sec><title>METHODS</title>This retrospective multicentre study in Japan comprised 81 patients with MDR-TB who developed linezolid-related adverse events during treatment with an initial standard dose of linezolid (600 mg).</sec><sec><title>RESULTS</title>Peripheral neuropathy, hematotoxicity, and optic neuropathy were the most frequent adverse events. Most patients with hematotoxicity improved with linezolid discontinuation or dose reduction. However, 20 of 44 patients (45%) with peripheral neuropathy and 2 out of 11 patients (18%) with optic neuropathy did not improve after 1 year of discontinuation. A longer duration from the onset of neuropathy to discontinuation and higher total dosage from the onset to discontinuation were risk factors for both residual peripheral neuropathy and optic neuropathy. Among the patients who discontinued linezolid owing to hematotoxicity, the recurrence rate was 19% (3/16) in those who re-administered linezolid at a low dose (300 mg).</sec><sec><title>CONCLUSION</title>If peripheral neuropathy or optic neuropathy occurs, continuous administration of linezolid may lead to long-term residual neuropathies. Re-administration of low-dose linezolid may be considered in cases of hematotoxicity.</sec>.

The International Journal of Tuberculosis and Lung DiseaseVol. 29(10)
National Archives and Records Administration (US), Nagara Medical Center (JP), Japan Anti Tuberculosis Association (JP), National Hospital Organization Hokkaido Medical Center (JP), Omuta hospital (JP), Nara City Hospital (JP), Nara Medical University Hospital (JP), National Hospital Organization (JP), Kanagawa Cardiovascular and Respiratory Center (JP), Fukujuji Hospital (JP), Tokyo National Hospital (JP), Nishi Niigata Chuo National Hospital (JP), Tokushima Hospital (JP), NHO Kinki Chuo Chest Medical Center (JP), Higashi Nagoya National Hospital (JP)
Openalex Percentile: Top 52%
Tuberculosis Research and Epidemiology
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