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http://dx.doi.org/10.4046/trd.2021.0122

Concise Clinical Review of Hematologic Toxicity of Linezolid in Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis: Role of Mitochondria  

Oehadian, Amaylia (Division of Hematology and Oncology Medic, Department of Internal Medicine Faculty of Medicine, Padjadjaran University/Dr. Hasan Sadikin General Hospital)
Santoso, Prayudi (Division of Hematology and Oncology Medic, Department of Internal Medicine Faculty of Medicine, Padjadjaran University/Dr. Hasan Sadikin General Hospital)
Menzies, Dick (McGill International TB Centre Respiratory Epidemiology and Clinical Research Unit)
Ruslami, Rovina (Division of Pharmacology, Department of Biomedical Science, Padjadjaran University/Dr. Hasan Sadikin General Hospital)
Publication Information
Tuberculosis and Respiratory Diseases / v.85, no.2, 2022 , pp. 111-121 More about this Journal
Abstract
Multidrug-resistant tuberculosis (MDR-TB) is caused by an organism that is resistant to both rifampicin and isoniazid. Extensively drug-resistant TB, a rare type of MDR-TB, is caused by an organism that is resistant to quinolone and one of group A TB drugs (i.e., linezolid and bedaquiline). In 2018, the World Health Organization revised the groupings of TB medicines and reclassified linezolid as a group A drug for the treatment of MDR-TB. Linezolid is a synthetic antimicrobial agent in the oxazolidinone class. Although linezolid has a good efficacy, it can cause substantial adverse events, especially hematologic toxicity. In both TB infection and linezolid mechanism of action, mitochondrial dysfunction plays an important role. In this concise review, characteristics of linezolid as an anti-TB drug are summarized, including its efficacy, pathogenesis of hematologic toxicity highlighting mitochondrial dysfunction, and the monitoring and management of hematologic toxicity.
Keywords
MDR-TB; XDR-TB; Linezolid; Hematologic Toxicity; Mitochondria;
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