Tolerability of linezolid in patients with drug-resistant TB in Daru, Western Province, PNG.

Abstract

Setting: Linezolid (LZD) has emerged as a critical agent and core component of regimens to treat drug-resistant TB (DR-TB); however, there are ongoing uncertainties regarding its safety and the optimal dosing approach. Since 2016, linezolid has been used in the treatment of patients diagnosed with DR-TB at Daru Provincial Hospital, PNG.

Objective: To describe the patient characteristics, treatment outcomes, and tolerability of linezolid-containing regimens used to treat DR-TB in Daru, Western Province.

Design: This was a retrospective analysis of programmatic data.

Results: A total of 632 eligible patients were diagnosed with DR-TB during the study period. Of these, 580 (91.8%) were commenced on a LZD-containing regimen. Among patients with baseline haemoglobin results available (380/632, 60.1%), the median value was 10.1 g/dL, with a mean corpuscular volume of 70.7 fL, 78.1% of those with haemoglobin results were anaemic at baseline. Despite this, 242/580 (41.7%) patients were able to complete the full LZD course of treatment (typically 18 months) without dose reduction or interruption. Treatment success was observed in 87.9% of the cohort. Neurotoxicity was not commonly reported, but adverse events were likely under-reported.

Conclusion: In this cohort, with high rates of baseline anaemia, prolonged therapy with LZD was relatively well tolerated.