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>.