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Adverse Drug Reaction to Linezolid in Drug-Resistant Tuberculosis: A Systematic Review
Emy Oktaviani1, Kusnandar Anggadiredja1, Lia Amalia1
1Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Bandung Institute of Technology, Bandung 40132, Indonesia.
Medical Sciences (Basel, Switzerland)
|January 21, 2026
Summary
Linezolid is effective for drug-resistant tuberculosis but causes adverse drug reactions (ADRs). Common ADRs include hematologic toxicity, neuropathy, and optic neuritis, necessitating careful monitoring.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Medicine
Background:
- Linezolid demonstrates efficacy in treating drug-resistant tuberculosis (DR-TB).
- However, linezolid use is associated with a significant risk of adverse drug reactions (ADRs), potentially impacting treatment outcomes.
- Understanding these ADRs is crucial for optimizing DR-TB management.
Purpose of the Study:
- To systematically review and describe linezolid-related adverse drug reactions in patients with drug-resistant tuberculosis.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Scopus, ProQuest, and Sage databases up to June 2023.
- Seven relevant articles were selected based on inclusion criteria, assessing linezolid-associated ADRs in DR-TB patients.
- Study quality and risk of bias were evaluated using the JBI checklist.
Main Results:
- The review identified hematologic toxicity, peripheral neuropathy, and optic neuritis as the most frequent linezolid-related ADRs.
- Gastrointestinal disorders and hyperlactatemia were also reported ADRs.
- Linezolid dosages varied (300-1200 mg/day), with 600 mg twice daily and 1200 mg daily being common.
Conclusions:
- Linezolid-associated ADRs are dependent on dosage and duration of treatment.
- Hematologic toxicity typically manifests early, while neuropathy and optic neuritis develop with prolonged use.
- Intensive monitoring and therapeutic drug monitoring are essential for safe linezolid administration in DR-TB patients.
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