Low minimal inhibitory concentrations of linezolid against multidrug-resistant tuberculosis strains

We are following the debate about the administration and the preferred dosage of linezolid in the treatment of multidrug-resistant (MDR) tuberculosis (TB) and extensively drug-resistant (XDR) TB with great interest. Linezolid is a high potent drug against M. tuberculosis , but its widespread use is limited due to severe side-effects in long-term treatment, which often occurs after the usage of 600 mg twice a day in bacterial disease for >28 days and mainly includes severe haematotoxic effects ( i.e. myelosuppression, anaemia, thrombocytopaenia) or polyneuropathy [1]. However, the current standards in MDR- and XDR-TB require several months of treatment. In addition, the administration of 1200 mg linezolid per day leads to high treatment costs, which limits the usage, especially in low-income countries [1, 2]. Lowering the dosage of linezolid could, therefore, be an effective step towards reducing costs and severe side-effects. Reducing linezolid dose in the treatment of MDR-/XDR-TB to a 300 mg OD could reduce severe side-effects and cost