Linezolid for the treatment of complicated drug-resistant tuberculosis: a systematic review and meta-analysis [Review article].

Hdl Handle:
http://hdl.handle.net/10144/241786
Title:
Linezolid for the treatment of complicated drug-resistant tuberculosis: a systematic review and meta-analysis [Review article].
Authors:
Cox, H; Ford, N
Journal:
International Journal of Tuberculosis and Lung Disease
Abstract:
BACKGROUND: Current treatment for drug-resistant tuberculosis (DR-TB) is inadequate, and outcomes are significantly poorer than for drug-susceptible TB, particularly for patients previously treated with second-line drugs, treatment failures or extensively drug-resistant (XDR-) TB patients (complicated DR-TB). Linezolid is not recommended for routine DR-TB treatment due to the lack of efficacy data, but is suggested for patients where adequate second-line regimens are difficult to design.OBJECTIVE: To conduct a systematic review and metaanalysis to assess existing evidence of efficacy and safety of linezolid for DR-TB treatment.METHODS: We searched PubMed, Embase and abstracts from World Conferences of The Union for studies published through February 2011. We included all studies in which linezolid was given systematically to DR-TB patients and where treatment outcomes were reported.RESULTS: A total of 11 studies were included in our review, representing 148 patients. The pooled proportion for treatment success was 67.99% (95%CI 58.00-78.99, τ2 129.42). There were no significant differences in success comparing daily linezolid dose (≤600 vs. >600 mg) and mean linezolid duration (≤7 vs. >7 months). The pooled estimate for the frequency of any adverse events was 61.48% (95%CI 40.15-82.80), with 36.23% (95%CI 20.67-51.79) discontinuing linezolid due to adverse events.CONCLUSION: Treatment success with linezolid was equal to or better than that commonly achieved for uncomplicated DR-TB, and better than previous reports for previously treated patients and those with XDR-TB. While data are limited, linezolid appears be a useful drug, albeit associated with significant adverse events, and should be considered in the treatment of complicated DR-TB.
Affiliation:
Médecins Sans Frontières, Khayelitsha, Cape Town, South Africa; Monash University, Melbourne, Victoria, Australia; ‡ Médecins Sans Frontières, London, UK; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa
Publisher:
Publisher International Union Against Tuberculosis and Lung Disease
Issue Date:
8-Feb-2012
URI:
http://hdl.handle.net/10144/241786
DOI:
10.5588/ijtld.11.0451
PubMed ID:
22325685
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed/22325685
Submitted date:
2011-06-30
Type:
Article
Language:
en
ISSN:
1815-7920
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorCox, Hen_GB
dc.contributor.authorFord, Nen_GB
dc.date.accessioned2012-09-07T12:21:48Z-
dc.date.available2012-09-07T12:21:48Z-
dc.date.issued2012-02-08-
dc.date.submitted2011-06-30-
dc.identifier.citationInt J Tuberc Lung Dis. 2012 Feb 8. [Epub ahead of print]en_GB
dc.identifier.issn1815-7920-
dc.identifier.pmid22325685-
dc.identifier.doi10.5588/ijtld.11.0451-
dc.identifier.urihttp://hdl.handle.net/10144/241786-
dc.description.abstractBACKGROUND: Current treatment for drug-resistant tuberculosis (DR-TB) is inadequate, and outcomes are significantly poorer than for drug-susceptible TB, particularly for patients previously treated with second-line drugs, treatment failures or extensively drug-resistant (XDR-) TB patients (complicated DR-TB). Linezolid is not recommended for routine DR-TB treatment due to the lack of efficacy data, but is suggested for patients where adequate second-line regimens are difficult to design.OBJECTIVE: To conduct a systematic review and metaanalysis to assess existing evidence of efficacy and safety of linezolid for DR-TB treatment.METHODS: We searched PubMed, Embase and abstracts from World Conferences of The Union for studies published through February 2011. We included all studies in which linezolid was given systematically to DR-TB patients and where treatment outcomes were reported.RESULTS: A total of 11 studies were included in our review, representing 148 patients. The pooled proportion for treatment success was 67.99% (95%CI 58.00-78.99, τ2 129.42). There were no significant differences in success comparing daily linezolid dose (≤600 vs. >600 mg) and mean linezolid duration (≤7 vs. >7 months). The pooled estimate for the frequency of any adverse events was 61.48% (95%CI 40.15-82.80), with 36.23% (95%CI 20.67-51.79) discontinuing linezolid due to adverse events.CONCLUSION: Treatment success with linezolid was equal to or better than that commonly achieved for uncomplicated DR-TB, and better than previous reports for previously treated patients and those with XDR-TB. While data are limited, linezolid appears be a useful drug, albeit associated with significant adverse events, and should be considered in the treatment of complicated DR-TB.en_GB
dc.languageENG-
dc.language.isoenen
dc.publisherPublisher International Union Against Tuberculosis and Lung Diseaseen_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/22325685en_GB
dc.rightsArchived with thanks to The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen_GB
dc.subjectDR-TBen_GB
dc.subjectTBen_GB
dc.titleLinezolid for the treatment of complicated drug-resistant tuberculosis: a systematic review and meta-analysis [Review article].en
dc.typeArticleen
dc.contributor.departmentMédecins Sans Frontières, Khayelitsha, Cape Town, South Africa; Monash University, Melbourne, Victoria, Australia; ‡ Médecins Sans Frontières, London, UK; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africaen_GB
dc.identifier.journalInternational Journal of Tuberculosis and Lung Diseaseen_GB

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