Dissemination of a Localized Cutaneous Infection With Mycobacterium chelonae Under Immunosuppressive Treatment

Hoetzenecker, Wolfram

doi:10.1001/archderm.143.7.951

Cited by 10 publications

(11 citation statements)

References 8 publications

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“…Europe, North America, and Asia) [8,22,[30][31][32][33][34][35][44][45][46][47] were collected (tables 1 and 4). More than half were males (53.7%) and were born in Asian countries (69.3%), with a median (IQR) age at treatment onset of 32 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) yrs. Known risk factors favouring the development of TB and MDR-/XDR-TB were detected in several patients: 35.4% were migrants from high TB-burden countries; 8.7% were HIV positive; and 76.9% were previously treated with anti-TB therapy .30 days (median (IQR) for the number of times exposed to anti-TB drugs was 1 (0-4)).…”

Section: Characteristics Of the International Cohortmentioning

confidence: 99%

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Efficacy, safety and tolerability of linezolid containing regimens in treating MDR-TB and XDR-TB: systematic review and meta-analysis

Sotgiu¹,

Centis²,

et al. 2012

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Linezolid is used off-label to treat multidrug-resistant tuberculosis (MDR-TB) in absence of systematic evidence. We performed a systematic review and meta-analysis on efficacy, safety and tolerability of linezolid-containing regimes based on individual data analysis.12 studies (11 countries from three continents) reporting complete information on safety, tolerability, efficacy of linezolid-containing regimes in treating MDR-TB cases were identified based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Metaanalysis was performed using the individual data of 121 patients with a definite treatment outcome (cure, completion, death or failure).Most MDR-TB cases achieved sputum smear (86 (92.5%) out of 93) and culture (100 (93.5%) out of 107) conversion after treatment with individualised regimens containing linezolid (median (inter-quartile range) times for smear and culture conversions were 43.5 (21-90) and 61 (29-119) days, respectively) and 99 (81.8%) out of 121 patients were successfully treated. No significant differences were detected in the subgroup efficacy analysis (daily linezolid dosage f600 mg versus .600 mg). Adverse events were observed in 63 (58.9%) out of 107 patients, of which 54 (68.4%) out of 79 were major adverse events that included anaemia (38.1%), peripheral neuropathy (47.1%), gastro-intestinal disorders (16.7%), optic neuritis (13.2%) and thrombocytopenia (11.8%). The proportion of adverse events was significantly higher when the linezolid daily dosage exceeded 600 mg.The study results suggest an excellent efficacy but also the necessity of caution in the prescription of linezolid.

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Section: Characteristics Of the International Cohortmentioning

confidence: 99%

“…Nevertheless, clinical experience on linezolid has been mainly restricted to case reports and small case series including both non-tuberculous mycobacterial diseases and TB [22][23][24][25][26][27][28][29].…”

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confidence: 99%

Efficacy, safety and tolerability of linezolid containing regimens in treating MDR-TB and XDR-TB: systematic review and meta-analysis

Sotgiu¹,

Centis²,

et al. 2012

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“…In vitro and pharmacological data suggest that linezolid, an oxazolidinone antibiotic, could be useful in treating mycobacterial infections, including MDR-TB [16][17][18][19][20][21][22][23]. However, clinical experience with linezolid for purposes outside the drug's approved uses has been restricted mainly to case reports in nontuberculous mycobacterial diseases [24][25][26][27][28][29]. Linezolid is used in both Eastern and Western Europe to treat MDR/XDR-TB, a purpose outside the drug's approved uses, but treatment costs are high.…”

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confidence: 99%

A retrospective TBNET assessment of linezolid safety, tolerability and efficacy in multidrug-resistant tuberculosis

Migliori¹,

Eker²,

Richardson³

et al. 2009

European Respiratory Journal

174

152

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Linezolid is used to treat patients with multidrug-resistant (MDR)/extensively drugresistant (XDR)-tuberculosis (TB) cases, although clinical data on its safety, tolerability and efficacy are lacking.We performed a retrospective, nonrandomised, unblinded observational study evaluating the safety and tolerability of linezolid at 600 mg q.d. or b.i.d. in MDR/XDR-TB treatment in four European countries. Efficacy evaluation compared end-points of 45 linezolid-treated against 110 linezolid-nontreated cases.Out of 195 MDR/XDR-TB patients, 85 were treated with linezolid for a mean of 221 days. Of these, 35 (41.2%) out of 85 experienced major side-effects attributed to linezolid (anaemia, thrombocytopenia and/or polyneuropathy), requiring discontinuation in 27 (77%) cases. Most side-effects occurred after 60 days of treatment. Twice-daily administration produced more major side-effects than once-daily dosing (p50.0004), with no difference in efficacy found. Outcomes were similar in patients treated with/without linezolid (p50.8), although linezolid-treated cases had more first-line (p50.002) and second-line (p50.02) drug resistance and a higher number of previous treatment regimens (4.5 versus 2.3; p50.07).Linezolid 600 mg q.d. added to an individualised multidrug regimen may improve the chance of bacteriological conversion, providing a better chance of treatment success in only the most complicated MDR/XDR-TB cases. Its safety profile does not warrant use in cases for which there are other, safer, alternatives.

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“…The first observation of the use of linezolid for treatment of an infection due to a clarithromycin resistant strain of M. chelonae was reported in 2001 . Since then, linezolid was used for a total of six more reported cases of M. chelonae infections including ours . In the four patients described here, a complete clinical resolution was noticed in patients after 1 month of treatment or less and no relapse was observed after long‐term follow‐up.…”

Section: Discussionmentioning

confidence: 62%

Induction therapy with linezolid/clarithromycin combination for Mycobacterium chelonae skin infections in immunocompromised hosts

Parize

Hamelin

Véziris

et al. 2015

Acad Dermatol Venereol

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Dissemination of a Localized Cutaneous Infection With Mycobacterium chelonae Under Immunosuppressive Treatment

Cited by 10 publications

References 8 publications

Efficacy, safety and tolerability of linezolid containing regimens in treating MDR-TB and XDR-TB: systematic review and meta-analysis

Efficacy, safety and tolerability of linezolid containing regimens in treating MDR-TB and XDR-TB: systematic review and meta-analysis

A retrospective TBNET assessment of linezolid safety, tolerability and efficacy in multidrug-resistant tuberculosis

Induction therapy with linezolid/clarithromycin combination for Mycobacterium chelonae skin infections in immunocompromised hosts

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