Linezolid associated peripheral neuropathy in patients with MDR/XDR tuberculosis

Abstract

Background and Objectives: Linezolid is one of the effective anti TB drugs used for the treatment of multi drug resistant/extensively drug resistant tuberculosis (MDR/XDR TB). Peripheral neuropathy is common adverse drug reaction seen with prolonged use of Linezolid. We aimed to study peripheral neuropathy in patients on Linezolid based regime for MDR/XDR TB. Methods: We observed all MDR/XDR TB patients over a period of 2 years on Linezolid based regime in our institute in Respiratory Medicine Department. On treatment patients who had signs and symptoms of peripheral neuropathy were enrolled, evaluated and followed. Results: Out of all patients observed, approximately 15 % developed peripheral neuropathy more commonly involving lower limbs. Maximum patients were young and without any co morbidity. In majority of patients, we had to stop Linezolid. In spite of adequate timely measures, significant number of patients had only partial improvement after 6 months. Conclusion: Significant number of patients developed peripheral neuropathy in our study. Early detection and immediate measures need to be taken to avoid serious permanent neurological consequences. We want to emphasize that a simple screening tool for detection of neuropathy needs to be adopted and incorporated in NTEP itself.

Keywords: Linezolid, MDR-TB, XDR-TB, Peripheral neuropathy