Clinical effectiveness and reliability of linezolid in the treatment of pulmonary tuberculosis complicated with severe pneumonia: a meta-analysis.

OBJECTIVE: To systematically evaluate the clinical effect and reliability of linezolid in the treatment of pulmonary tuberculosis complicated with severe pneumonia. METHODS: A comprehensive search was conducted to screen the published literature on linezolid therapy in pulmonary tuberculosis complicated with severe pneumonia in PubMed, Embase, Web of Science, Cochrane Library, and published databases of China National Knowledge Infrastructure. After screening the internal data of the literature, the quality of the literature was assessed uniformly. RevMan5.3 was used for meta-analysis. RESULTS: The search identified 1202 clinical patients in 24 articles. Meta-analysis results revealed that linezolid treatment was associated with better bacterial clearance rate (OR=3.66 [2.41, 5.58], P<0.001) and superior total clinical effective rate (OR=5.80 [3.92, 8.58], P<0.001) in patients. The linezolid treatment resulted in lower levels of serum inflammatory factors TNF-α (WMD=-10.75 [-13.63, -7.87], P<0.001), IL6 (WMD=-10.16 [-13.50, -6.82], P<0.001), and IL8 (WMD=-8.31 [-10.41, -6.21], P<0.001). There was no obvious distinction in the occurrence of adverse reactions between the linezolid group and the control group (OR=1.34 [0.86, 2.08], P=0.19). CONCLUSION: Linezolid combined with conventional anti-tuberculosis treatment has a better bacterial clearance rate and clinical total effective rate than conventional anti-tuberculosis programs with reliable safety.