Safety of Longer Linezolid Regimen in Children with Drug Resistance Tuberculosis and Extensive Tuberculosis in Southwest China

Abstract Objective Linezolid (LZD) has been listed as the group A medications for the treatment of multi-drug resistance tuberculosis (MDR-TB) and extensive drug resistance tuberculosis (XDR-TB) in longer regimen (18-20 month) by WHO recently. However, little is known about the safety of LZD in longer TB treatment regimen in children. Methods Here, we reported 31children who received LZD treatment for drug resistance tuberculosis (DR-TB) and extensive tuberculosis from September, 2016 to March 2019. The average course of LZD treatment was 8.56 months (range from 1 m to 24 m). Results 3/31patients (41.94%) had suspected or confirmed adverse events (AEs) related to LZD including digestive symptom, hematologic toxicity, neuropathy and lactic acidosis. Hematologic toxicity were the most frequent AEs presented as leukopenia (9/13) and anemia (5/13). No hepatotoxic and nephrotoxic were observed in all 31 patients. Two patients suffered from life-threaten lactic acidosis when LZD dose increased to 1.2 g daily, and they finally recovered through LZD retrieving. Conclusion There was high rate of AEs of Linezolid treatment in children who received long time regimen, and the AEs might relate to treat course and dose. Hematologic toxicity was the most frequent AE in children. It is necessary to monitor the blood test and lactic concentration regularly during Linezolid treatment.