Abstract:

Objective To evaluate the clinical efficacy and safety of linezolid in the treatment of postoperative patients with multidrug-resistant spinal tuberculosis. Methods From May 2013 to April 2017,16 multidrug-resistant spinal tuberculosis patients admitted to the orthopedics department, Beijing Chest Hospital were selected. After the operation, the anti-tuberculosis drugs treatment for 6 months without linezolid were ineffective, and then the patients changed to the linezolid-containing regimen for anti-tuberculosis treatment. Evaluating the clinical efficacy and safety of linezolid-containing regimen in the treatment of postoperative multidrug-resistant spinal tuberculosis by comparing the success rate of treatment, the rate of bone graft fusion, the change of visual analogue scale (VAS) and the occurrence of adverse effects related to linezolid before and after the adjustment of anti-tuberculosis treatment regimen. Results The success rate of the treatment with linezolid-containing regimen was 75.0% (12/16), the failure rate was 25.0% (4/16), and the bone graft fusion rate was 81.3% (13/16). The average VAS score for the treatment without linezolid was(5.8±1.4) points, compared with the average VAS score of the linezolid-containing regimen was (2.3±1.5), and the difference was statistically significant (t=6.546,P=0.000). The vertebral infection and paravertebral abscess of 12 patients were gradually absorbed. The incidence of adverse reactions associated with linezolid was 56.3% (9/16) totally. The incidence of gastrointestinal adverse reactions, peripheral neuritis, anemia, dizziness, rash was 31.3% (5/16), 43.8% (7/16), 37.5% (6/16), 12.5% (2/16), and 6.3% (1/16), respectively. The severity of adverse reactions was reduced after reducing the dose of linezolid. Conclusion The clinical efficacy of the linezolid-containing regimen in the treatment of multidrug-resistant spinal tuberculosis is definite, but there is a high incidence of adverse effects related to the dose of linezolid.

Key words: Tuberculosis, spinal, Tuberculosis, multidrug-resistant, Drug therapy, combination, Comparative effectiveness research, Linezolid