| Abstrakt: |
Objective To evaluate the efficacy and safety of different initial doses of linezolid combined with bedaquiline in the treatment of multidrug-resistant tuberculosis (MDR-TB). Methods Totally 51 patients with MDR-TB who had completed the course of treatment with bedaquiline combined with linezolid in the outpatient and inpatient departments of Chengdu Public Health Clinical Medical Center from March 2018 to April 2021 were divided into two groups, according to the initial dose of linezolid, including 23 cases in 1 200 mg/d group and 28 cases in 600 mg/d group. The epidemiological characteristics, treatment, adverse events and prognosis of the two groups were analyzed. Results In the treatment of MDR-TB patients combined with bedaquiline, the success rate of linezolid at the initial dose of 1 200 mg/d and the initial dose of 600 mg/d group was equivalent, respectively 82.6% (19/23) and 96.4% (27/28), the difference was not statistically significant (P> 0.05). The incidence of adverse events was 100% in both groups, and there was no significant difference in the incidence of QTc prolongation, myelosuppression, peripheral neuritis and optic neuritis among patients with different initial doses (P>0.05). However, the rate of linezolid treatment needing adjustment due to adverse events was 73.9% (17/23) in patients with initial dose of 1 200 mg/d, which was higher than 46.4% (13/28) of patients with linezolid initial dose of 600 mg/d (P=0.047). Among them, the proportion of linezolid discontinued due to adverse events in the linezolid initial dose of 1 200 mg/d group was 65.2% (15/23), which was higher than 25.0% (7/28) of the linezolid initial dose of 600 mg/d group (P=0.004). Conclusions Patients receiving linezolid at a initial dose of 600 mg/d had similar favourable outcomes to those receiving linezolid at a initial dose of 1 200 mg/d, but the tolerance of initial dose of 600 mg/d was better. It was recommended that when linezolid combined with bedaquiline was used to treat MDR-TB, the dose could be preferentially selected as 600 mg/d. [ABSTRACT FROM AUTHOR] |
