Current Review of the Use of Linezolid in the Treatment of Multidrug-Resistant Tuberculosis: Effectiveness and Management of Side Effects

In recent years, multi-drug resistant tuberculosis (MDR-TB) sufferers have increased by 10% from 186,883 sufferers in 2018 to 206,030 in 2019. MDR TB treatment poses its own challenges because it is a long-term treatment, there are interactions between TB treatment, toxicity problems and patient compliance. Linezolid has demonstrated high in vitro antibacterial activity against Mycobacterium tuberculosis and has been used in several programs to treat complications of MDR-TB. The objective of this study is to assess the effectiveness and management of side effects from using the drug Linezolid in multidrug-resistant tuberculosis patients. The data sources used were PubMed, PubMed Central (PMC), and ScienceDirect databases with a literature search without restrictions on the type of research or year of publication with the keywords "linezolid, "tuberculosis" and "multi-drug resistance". A final journal review found that Linezolid was effective in treating MDR-TB patients. The side effect experienced by patients from using lizenolide (LZD) in all articles was peripheral neuropathy in the first three months of LZD use but this could be overcome by administering B6 at a dose of 200 mg, mecobalamin, reducing the dose of LZD and there was 1 article that stopped giving LZD. Optic neuropathy was also experienced by patients in 4 articles and could be resolved by stopping LZD use. One article stated that the side effect of using LZD was diabetic neuropathy with urine protein (+) and the patient's condition returned to normal after receiving symptomatic treatment. Hematological side effects in the form of neutropenia, thrombocytopenia, myelosuppression, and mild to severe anemia were also experienced by patients and could be treated with blood transfusions for severe anemia in 1 article, administration of erythropoietin in 2 articles to treat anemia. reducing the LZD dose from 1200 mg per day to 600 mg per day and some even stopping LZD. The results of the literature review indicate that linezolid is effective in treating MDR-TB. However, close monitoring is required regarding the side effects experienced by patients, especially neurotoxicity effects (peripheral or optic neuropathy).