A Case Report and Literature Review of the Outcome of Linezolid-Induced Optic and Peripheral Neuropathy in Patients With Multidrug-Resistant Pulmonary TB

Bano, Safia; Nawaz, Ahmad; Numan, Ahsan; Hassan, Muhammad Aarish; Shafique, Muhammad Bilal Ahmad

doi:10.3389/fneur.2022.908584

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…Data from [5,9–11,15–23,32,34,39 ▪ ,40 ▪ ,41–57,58 ▪ ,59–66]. MRSA, methicillin-resistant staphylococcus aureus; TB, tuberculosis.…”

Section: Characteristics Of Linezolid-associated Optic Neuropathymentioning

confidence: 99%

Linezolid optic neuropathy

Miller,

Cao,

McClelland

et al. 2023

Current Opinion in Ophthalmology

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Purpose of review In this article, we reviewed 67 reported cases of linezolid optic neuropathy and describe the common characteristics and expectations for recovery with an emphasis on recent findings in the literature. Recent findings Linezolid classically causes a reversible, duration-dependent optic neuropathy. However, in our review, we found only 66.7% of patients recovered complete visual function. Vision loss most commonly affected visual acuity followed by visual field and color vision. We also found patients taking higher doses of linezolid experienced full recovery less often, suggesting a dose-dependent component of linezolid optic neuropathy. Linezolid use has increased in frequency and duration, especially in the treatment of drug-resistant tuberculosis, and data indicate that these patients experience lower rates of complete vision recovery compared with patients taking linezolid for other indications. Summary Linezolid is an effective medication for treating drug-resistant infections; however, it may result in optic neuropathy. It is reasonable for patients on linezolid to undergo screening examinations, especially those on higher doses or for prolonged duration of therapy.

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“…Data from [5,9–11,15–23,32,34,39 ▪ ,40 ▪ ,41–57,58 ▪ ,59–66]. MRSA, methicillin-resistant staphylococcus aureus; TB, tuberculosis.…”

Section: Characteristics Of Linezolid-associated Optic Neuropathymentioning

confidence: 99%

Linezolid optic neuropathy

Miller,

Cao,

McClelland

et al. 2023

Current Opinion in Ophthalmology

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Isoniazid/linezolid/rifampicin

2022

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Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease

Haley,

Schechter,

Ashkin

et al. 2023

Clinical Infectious Diseases

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Background Rifampin-resistant tuberculosis is a leading cause of morbidity worldwide; only one-third of persons initiate treatment and outcomes are often inadequate. Several trials demonstrate 90% efficacy using an all-oral, six-month regimen of bedaquiline, pretomanid, and linezolid (BPaL), but significant toxicity occurred using 1200 mg linezolid. After U.S. FDA approval in 2019, some U.S. clinicians rapidly implemented BPaL using an initial linezolid 600 mg dose adjusted by serum drug concentrations and clinical monitoring. Methods Data from U.S. patients treated with BPaL between 10/14/2019 and 4/30/2022 were compiled and analyzed by the BPaL Implementation Group (BIG), including baseline examination and laboratory, electrocardiographic, and clinical monitoring throughout treatment and follow-up. Linezolid dosing and clinical management was provider-driven, and most had linezolid adjusted by therapeutic drug monitoring (TDM). Results Of 70 patients starting BPaL, two changed to rifampin-based therapy, 68 (97.1%) completed BPaL, and two of these 68 (2.9%) patients relapsed after completion. Using an initial 600 mg linezolid dose daily adjusted by TDM and careful clinical and laboratory monitoring for side effects, supportive care, and expert consultation throughout BPaL treatment, three (4.4%) patients with hematologic toxicity and four (5.9%) with neurotoxicity required a change in linezolid dose or frequency. The median BPaL duration was 6 months. Conclusions BPaL has transformed treatment for rifampin-resistant or intolerant tuberculosis. In this cohort, effective treatment required less than half the duration recommended in ATS/CDC/ERS/IDSA 2019 guidelines for drug-resistant tuberculosis. Use of individualized linezolid dosing and monitoring likely enhanced safety and treatment completion. The BIG cohort demonstrates that early implementation of new tuberculosis treatments in the U.S. is feasible.

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A Case Report and Literature Review of the Outcome of Linezolid-Induced Optic and Peripheral Neuropathy in Patients With Multidrug-Resistant Pulmonary TB

Cited by 4 publications

References 14 publications

Linezolid optic neuropathy

Linezolid optic neuropathy

Isoniazid/linezolid/rifampicin

Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease

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