The Structure, Properties, and Clinical Utility of Contezolid for Antituberculosis: A Narrative Review

Tuberculosis (TB) continues to represent a significant global public health concern, with China being a country that bears the burden of a high incidence of TB cases on a global scale. Although linezolid (LZD) has been recommended for treating drug-resistant tuberculosis (DR-TB), its intolerability and adverse events, such as myelosuppression, neurotoxicity, etc., have limited its long-term usage in anti-TB treatment. Contezolid (CZD), a new generation of oxazolidinone drug, shows comparable or superior antibacterial activity to LZD, with lower risks of myelosuppressive toxicity, neurotoxicity, and lactic acidosis. Its unique metabolic pathway and favorable pharmacokinetic profile render it a promising alternative to LZD for TB treatment. Recent years have seen mounting evidence of the potential of CZD in treating TB. In this paper, the development history, the mode of action, resistance mechanisms, and research progress on CZD for TB treatment are reviewed, aiming to enhance understanding of its role in anti-TB therapy and to provide valuable references for clinical use and future research.