Chest Infections |

Efficacy and Safety of Linezolid for the Treatment of Extensively Drug Resistant Tuberculosis: A Prospective, Multicenter, Randomized Study in China FREE TO VIEW

Shenjie Tang, PhD; Lan Yao, PhD; Xiaohui Hao, PhD; Xia Zhang, PhD; Gang Liu, PhD; Xin Liu, PhD; Meiying Wu, PhD; Linhai Zeng, PhD; Hua Sun, PhD; Yidian Liu, MD; Jin Gu, MD; Feishen Lin, MD; Xiafang Wang, MD; Zhanjun Zhang, MD
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Shanghai Pulmonary Hospital, Shanghai, China

Chest. 2014;145(3_MeetingAbstracts):153A. doi:10.1378/chest.1836150
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SESSION TITLE: Respiratory Infections

SESSION TYPE: Slide Presentations

PRESENTED ON: Sunday, March 23, 2014 at 04:15 PM - 05:15 PM

PURPOSE: The treatment of XDR-TB is less effective than that of other forms of TB because of the lack of efficacious anti-TB drugs so that the infection is frequently fatal. To investigate the efficacy and safety of linezolid containing chemotherapy in patients with XDR-TB in China.

METHODS: We conducted a multicenter, prospective, randomized, controlled trial in five large-scale Tuberculosis Specialized Hospitals in China. 65 patients were randomly assigned to linezolid therapy group and control group. Patients in two groups were adopted two years of individual-based chemotherapy regimens based on the patient medication history and drug susceptibility test results. Linezolid therapy group was added to linezolid that started at a dose of 1200 mg per day for 4 to 6 weeks, followed by 300 to 600 mg per day for at least 6 months. Sputum conversion rate, cavity closure rate, treatment outcomes and adverse events were compared between two groups.

RESULTS: The proportion of sputum-culture conversion in the Lzd group was 78.8% by 24 m, significantly higher than that in the control group (37.6%, P < 0.001). The cavity closure rate in the Lzd group was 69.7% by the end 24th month respectively, significantly higher than that of the control group (P <0.05). The treatment success rate in Lzd group was 69.7%, significantly higher than that in control group (34.4%, P<0.004), whereas poor treatment outcomes were more common in control group than in the Lzd group (65.6 vs. 30.3%; P=0.004). 27 (81.8%) patients had clinically significant adverse events in the Lzd group, of whom 25 patients (75.8%) had events that were possibly or probably related to linezolid. Most adverse events resolved after reducing the dosage of linezolid or temporarily discontinuing linezolid.

CONCLUSIONS: Linezolid containing chemotherapy for treatment of XDR-TB may significantly promote cavity closure, accelerate sputum culture conversion and improve treatment success rates. Meanwhile adverse reaction might be tolerated and resolve after suitable intervention.

CLINICAL IMPLICATIONS: This study provides important evidence for the treatment of XDR-TB using Linezoild.

DISCLOSURE: The following authors have nothing to disclose: Shenjie Tang, Lan Yao, Xiaohui Hao, Xia Zhang, Gang Liu, Xin Liu, Meiying Wu, Linhai Zeng, Hua Sun, Yidian Liu, Jin Gu, Feishen Lin, Xiafang Wang, Zhanjun Zhang

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