Villar, Miguel and Sotgiu, Giovanni and D’Ambrosio, Lia and Raymundo, E. and Fernandes, L. and Barbedo, J. and Diogo, Nelson and Lange, Christoph and Centis, Rosella and Migliori, Giovanni Battista (2011) Linezolid safety, tolerability and efficacy to treat multidrug- and extensively drug-resistant tuberculosis. European Respiratory Journal, Vol. 38 (3), p. 730-733. eISSN 1399-3003. Article.
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Treatment of multidrug-resistant (MDR) tuberculosis (TB) (defined as in vitro resistance to at least isoniazid and rifampicin, the two most potent first-line drugs for TB treatment) and extensively drug-resistant (XDR)-TB (defined as in vitro resistance to isoniazid and rifampicin plus any fluoroquinolone and at least one of the injectable drugs: amikacin, capreomycin or kanamycin) is still a major problem from both a clinical and a public health perspective[ 1– 5]. Treatment outcomes for complicated MDR-TB cases (those with additional resistance beyond isoniazid and rifampicin) and XDR-TB cases being still poor, the need for information on the safety, tolerability and efficacy of other antibiotics that are potentially useful in their treatment is urgent [ 6– 9]. In vitro and pharmacological data suggest that linezolid, an oxazolidinone antibiotic, could be useful in treating mycobacterial infections, including MDR-TB [ 9– 11]. However, clinical experience with the off-label use of linezolid is still limited to case reports and small case series involving nontuberculous mycobacterial diseases [ 12] and TB, the four largest cohorts including 10 [ 13], 12 [ 14], 30 [ 15] and 85 cases (but only 45 with information on efficacy) [ 9], respectively. The aim of this study was to evaluate the safety, tolerability and efficacy of linezolid in a cohort of patients with MDR/XDR-TB from Portugal.
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