Linezolid for the treatment of complicated drug-resistant tuberculosis: a systematic review and meta-analysis [Review article]
OBJECTIVE: To conduct a systematic review and meta-analysis 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.
Document Type: Research Article
Affiliations: 1: Médecins Sans Frontières, Khayelitsha, Cape Town, South Africa; Monash University, Melbourne, Victoria, Australia 2: Médecins Sans Frontières, London, UK; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa
Publication date: 01 April 2012
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