Linezolid-Associated Neuropathy in Patients with MDR/XDR Tuberculosis in Shenzhen, China
Peize Zhang,1,2 Wei Li,3 Miaona Liu,3 Senlin Zhan,2 Hailin Zhang,2 Guofang Deng,2 Xiaoyou Chen1 1Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People’s Republic of China; 2Department of Pulmonary Medicine and Tuberculosis, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, P...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2022-05-01
|
| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/linezolid-associated-neuropathy-in-patients-with-mdrxdr-tuberculosis-i-peer-reviewed-fulltext-article-IDR |
| _version_ | 1818238445462487040 |
|---|---|
| author | Zhang P Li W Liu M Zhan S Zhang H Deng G Chen X |
| author_facet | Zhang P Li W Liu M Zhan S Zhang H Deng G Chen X |
| author_sort | Zhang P |
| collection | DOAJ |
| description | Peize Zhang,1,2 Wei Li,3 Miaona Liu,3 Senlin Zhan,2 Hailin Zhang,2 Guofang Deng,2 Xiaoyou Chen1 1Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People’s Republic of China; 2Department of Pulmonary Medicine and Tuberculosis, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 3Department of Pharmacy, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Guofang Deng; Xiaoyou Chen, Email jxxk1035@yeah.net; chenxy1998@hotmail.comObjective: Linezolid is one of the key drugs for the treatment of multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB). We aimed to describe the incorporation of the Michigan Neuropathy Screening Instrument (MNSI) and serum trough concentration as screening tools for neurotoxicity in the management of MDR/XDR-TB patients receiving a linezolid-based treatment regimen in Shenzhen, China.Methods: A total of 73 patients on a linezolid-containing anti–MDR/XDR-TB regimen were prospectively enrolled. The MNSI was used for peripheral neuropathy screening. Optic neuropathy was diagnosed by ophthalmologists. Serum trough concentration was recorded and its relationship with neuropathy analyzed.Results: Of all patients, neuropathy was observed in 40% (29) during anti-TB treatment. Of these, 20 (69%) had peripheral neuritis, seven (24%) optic neuritis, and two (7%) both. Serum trough concentration > 2 mg/L was observed in 17 (59%) patients with neuropathy and 13 (30%) patients without neuropathy. There was a significant statistical difference between the two groups (P=0.013). Time to onset of neuropathy from initiation of the linezolid-containing regimen was within 2 months for eight (28%) patients, 2– 6 months for 18 (62%) patients, and > 6 months for three (10%) patients. Sixteen (55%) patients were adjusted to a lower dose of 300 mg linezolid daily. Four (14%) patients had linezolid permanently removed from their regimen.Conclusion: Neuropathy is a commonly reported adverse event associated with long-term use of linezolid. MNSI and serum trough–concentration monitoring can be adopted as simple screening tools for early detection of neuropathy to balance linezolid efficacy and tolerability.Keywords: linezolid, MDR/XDR-TB, neuropathy, MNSI, serum trough concentration |
| first_indexed | 2024-12-12T12:41:46Z |
| format | Article |
| id | doaj.art-90a5d20953294a35840c5c4b7eec3b0b |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-12-12T12:41:46Z |
| publishDate | 2022-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-90a5d20953294a35840c5c4b7eec3b0b2022-12-22T00:24:12ZengDove Medical PressInfection and Drug Resistance1178-69732022-05-01Volume 152617262475466Linezolid-Associated Neuropathy in Patients with MDR/XDR Tuberculosis in Shenzhen, ChinaZhang PLi WLiu MZhan SZhang HDeng GChen XPeize Zhang,1,2 Wei Li,3 Miaona Liu,3 Senlin Zhan,2 Hailin Zhang,2 Guofang Deng,2 Xiaoyou Chen1 1Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People’s Republic of China; 2Department of Pulmonary Medicine and Tuberculosis, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 3Department of Pharmacy, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Guofang Deng; Xiaoyou Chen, Email jxxk1035@yeah.net; chenxy1998@hotmail.comObjective: Linezolid is one of the key drugs for the treatment of multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB). We aimed to describe the incorporation of the Michigan Neuropathy Screening Instrument (MNSI) and serum trough concentration as screening tools for neurotoxicity in the management of MDR/XDR-TB patients receiving a linezolid-based treatment regimen in Shenzhen, China.Methods: A total of 73 patients on a linezolid-containing anti–MDR/XDR-TB regimen were prospectively enrolled. The MNSI was used for peripheral neuropathy screening. Optic neuropathy was diagnosed by ophthalmologists. Serum trough concentration was recorded and its relationship with neuropathy analyzed.Results: Of all patients, neuropathy was observed in 40% (29) during anti-TB treatment. Of these, 20 (69%) had peripheral neuritis, seven (24%) optic neuritis, and two (7%) both. Serum trough concentration > 2 mg/L was observed in 17 (59%) patients with neuropathy and 13 (30%) patients without neuropathy. There was a significant statistical difference between the two groups (P=0.013). Time to onset of neuropathy from initiation of the linezolid-containing regimen was within 2 months for eight (28%) patients, 2– 6 months for 18 (62%) patients, and > 6 months for three (10%) patients. Sixteen (55%) patients were adjusted to a lower dose of 300 mg linezolid daily. Four (14%) patients had linezolid permanently removed from their regimen.Conclusion: Neuropathy is a commonly reported adverse event associated with long-term use of linezolid. MNSI and serum trough–concentration monitoring can be adopted as simple screening tools for early detection of neuropathy to balance linezolid efficacy and tolerability.Keywords: linezolid, MDR/XDR-TB, neuropathy, MNSI, serum trough concentrationhttps://www.dovepress.com/linezolid-associated-neuropathy-in-patients-with-mdrxdr-tuberculosis-i-peer-reviewed-fulltext-article-IDRlinezolidmdr/xdr-tbneuropathymnsiserum trough concentration; |
| spellingShingle | Zhang P Li W Liu M Zhan S Zhang H Deng G Chen X Linezolid-Associated Neuropathy in Patients with MDR/XDR Tuberculosis in Shenzhen, China Infection and Drug Resistance linezolid mdr/xdr-tb neuropathy mnsi serum trough concentration; |
| title | Linezolid-Associated Neuropathy in Patients with MDR/XDR Tuberculosis in Shenzhen, China |
| title_full | Linezolid-Associated Neuropathy in Patients with MDR/XDR Tuberculosis in Shenzhen, China |
| title_fullStr | Linezolid-Associated Neuropathy in Patients with MDR/XDR Tuberculosis in Shenzhen, China |
| title_full_unstemmed | Linezolid-Associated Neuropathy in Patients with MDR/XDR Tuberculosis in Shenzhen, China |
| title_short | Linezolid-Associated Neuropathy in Patients with MDR/XDR Tuberculosis in Shenzhen, China |
| title_sort | linezolid associated neuropathy in patients with mdr xdr tuberculosis in shenzhen china |
| topic | linezolid mdr/xdr-tb neuropathy mnsi serum trough concentration; |
| url | https://www.dovepress.com/linezolid-associated-neuropathy-in-patients-with-mdrxdr-tuberculosis-i-peer-reviewed-fulltext-article-IDR |
| work_keys_str_mv | AT zhangp linezolidassociatedneuropathyinpatientswithmdrxdrtuberculosisinshenzhenchina AT liw linezolidassociatedneuropathyinpatientswithmdrxdrtuberculosisinshenzhenchina AT lium linezolidassociatedneuropathyinpatientswithmdrxdrtuberculosisinshenzhenchina AT zhans linezolidassociatedneuropathyinpatientswithmdrxdrtuberculosisinshenzhenchina AT zhangh linezolidassociatedneuropathyinpatientswithmdrxdrtuberculosisinshenzhenchina AT dengg linezolidassociatedneuropathyinpatientswithmdrxdrtuberculosisinshenzhenchina AT chenx linezolidassociatedneuropathyinpatientswithmdrxdrtuberculosisinshenzhenchina |