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Linezolid-containing Treatment Regimens for Tuberculosis in Children
Luis M Prieto1, Begoña Santiago2, Teresa Del Rosal3
1From the Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
Insights
Linezolid shows promise for treating drug-resistant tuberculosis (TB) in children, even in cases of liver issues. Close monitoring for adverse events is crucial, with further research needed for optimal dosing and duration.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and therapeutics
- Tuberculosis research
Background:
- Growing interest in linezolid for tuberculosis (TB) treatment.
- Assessing linezolid's role in pediatric TB management.
Purpose of the Study:
- Evaluate linezolid treatment characteristics, adverse events, and outcomes in children.
- Determine the safety and efficacy of linezolid in pediatric TB patients.
Main Methods:
- Retrospective study of pediatric patients (<18 years) treated with linezolid.
- Inclusion criteria: Spanish Pediatric TB Network, 2001-2016.
- Analysis of treatment duration, adverse events, and patient outcomes.
Main Results:
- Fifteen children (median age 3.6 years) received linezolid for drug-resistant TB, liver injury, or liver disease.
- Common adverse events included hematologic toxicity (53%) and gastrointestinal intolerance (20%).
- High treatment success rate (93%) with no observed relapses in 14 patients.
Conclusions:
- Linezolid is a potential option for drug-resistant TB in children, and for those with liver conditions.
- Close monitoring of adverse events is essential during linezolid therapy.
- Further research is required to establish optimal pediatric dosing and treatment duration.
Background:
In recent years, there is an increasing interest in the use of linezolid for the treatment of tuberculosis (TB).
Methods:
Patients less than 18 years of age who received linezolid within the Spanish Pediatric TB Network from 2001 to 2016 were retrospectively included. Treatment characteristics, adverse events (AEs) and outcomes were analyzed.
Results:
Fifteen children were included (53% male) with a median age of 3.6 years [interquartile range (IQR): 1.6-6.2]. Median follow-up was 54 months (IQR: 38-76). The reasons for linezolid use were drug-resistant TB in 8 (53%) patients, drug-induced liver injury in 5 (33%) patients and chronic liver disease in 2 (13%) patients. Four children (26%) were on immunosuppressive therapy when TB was diagnosed. Five children (33%) were diagnosed with extrapulmonary TB. The median duration of linezolid treatment was 13 months (IQR: 7.5-17). Nine patients had 13 linezolid-related AEs. Hematologic toxicity was observed in 8 patients (53%) and gastrointestinal intolerance in 3 patients (20%). In 2 patients, linezolid dose was reduced, and in 2 patients, linezolid was discontinued because of AEs. A 2-year-old girl went back to her country of birth and was lost to follow-up. No relapses were observed among the other 14 patients (93%).
Conclusions:
Linezolid may be considered when treating children with drug-resistant TB but also in the cases of patients with chronic liver disease or drug-induced liver injury. However, AEs should be closely monitored. Further studies are needed to determine the optimum dosage and the optimal duration of linezolid treatment in children.
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