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Substitution of ethambutol with linezolid during the intensive phase of treatment of pulmonary tuberculosis: A prospective, multicentre, randomised, open-label, phase 2 trial

The Lancet Infectious Diseases Dec 25, 2018

Lee JK, et al. - Researchers investigated the proportion of sputum culture conversion at 8 weeks of treatment using linezolid instead of ethambutol in patients with pulmonary tuberculosis. In this phase 2, multicentre, randomized, open-label trial for patients with pulmonary tuberculosis at the three affiliated hospitals to Seoul National University and National Medical Center (Seoul–Seongnam, South Korea). They randomly assigned patients, aged 20–80 years, with a positive sputum for pulmonary tuberculosis, but without resistance to rifampicin, and current treatment administered for 7 days or fewer, at a 1:1:1 ratio into three groups. The control group was administered ethambutol (2 months) with isoniazid, rifampicin, and pyrazinamide. Instead of ethambutol for 2 months, the second group used linezolid (600 mg/day) for 2 weeks and the third group for 4 weeks. Short-term use of linezolid led to no higher rates of culture conversion at 8 weeks of treatment. However, safety analyses and the resistance profile suggest that linezolid has potential role in shortening of treatment for drug-susceptible tuberculosis.
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