Effectiveness and safety of regimens containing linezolid for treatment of Mycobacterium abscessus pulmonary Disease

Ann Clin Microbiol Antimicrob. 2023 Dec 6;22(1):106. doi: 10.1186/s12941-023-00655-2.

Abstract

Objective: To evaluate the effectiveness and safety of linezolid-containing regimens for treatment of M. abscessus pulmonary disease.

Methods: The records of 336 patients with M. abscessus pulmonary disease who were admitted to Shanghai Pulmonary Hospital from January 2018 to December 2020 were retrospectively analyzed. A total of 164 patients received a linezolid-containing regimen and 172 controls did not. The effectiveness, safety, antibiotic susceptibility profiles, outcomes, culture conversion, cavity closure, and adverse reactions were compared in these two groups.

Results: The two groups had similar treatment success (56.1% vs. 48.8%; P > 0.05), but treatment duration was shorter in the linezolid group (16.0 months [inter-quartile ranges, IQR: 15.0-17.0] vs. 18.0 months [IQR: 16.0-18.0]; P < 0.01). The rates of sputum culture conversion were similar (53.7% vs. 46.5%, P > 0.05), but time to conversion was shorter in the linezolid group (3.5 months [IQR: 2.5-4.4] vs. 5.5 months [IQR: 4.0-6.8]; P < 0.01). The linezolid group had a higher rate of cavity closure (55.2% vs. 28.6%, P < 0.05) and a shorter time to cavity closure (3.5 months [IQR: 2.5-4.4] vs. 5.5 months [IQR: 4.0-6.8]; P < 0.01). Anemia and peripheral neuropathy were more common in the linezolid group (17.7% vs. 1.7%, P < 0.01; 12.8% vs. 0.6%, P < 0.01).

Conclusions: The linezolid and control groups had similar treatment success rates. The linezolid group had a shorter treatment duration, shorter time to sputum culture conversion, and higher rate and shorter time to lung cavity closure. More patients receiving linezolid developed anemia and peripheral neuropathy.

Keywords: Linezolid; Mycobacterium abscessus; Pulmonary Disease; Treatment.

MeSH terms

  • Anemia* / chemically induced
  • Anemia* / drug therapy
  • Anti-Bacterial Agents / adverse effects
  • China
  • Humans
  • Linezolid / adverse effects
  • Lung Diseases* / chemically induced
  • Lung Diseases* / drug therapy
  • Lung Diseases* / microbiology
  • Mycobacterium Infections, Nontuberculous* / drug therapy
  • Mycobacterium abscessus*
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / drug therapy
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Linezolid
  • Anti-Bacterial Agents