Efficacy and tolerability of linezolid as an adjunctive treatment for nontuberculous mycobacterial infections in patients with adult-onset immunodeficiency syndrome: a prospective cohort study
Issued Date
2026-01-01
Resource Type
ISSN
07853890
eISSN
13652060
Scopus ID
2-s2.0-105039269690
Journal Title
Annals of Medicine
Volume
58
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Annals of Medicine Vol.58 No.1 (2026)
Suggested Citation
Phoompoung P., Chavapradit N., Foongladda S., Chirapapaisan N., Suputtamongkol Y., Angkasekwinai N. Efficacy and tolerability of linezolid as an adjunctive treatment for nontuberculous mycobacterial infections in patients with adult-onset immunodeficiency syndrome: a prospective cohort study. Annals of Medicine Vol.58 No.1 (2026). doi:10.1080/07853890.2026.2674358 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116965
Title
Efficacy and tolerability of linezolid as an adjunctive treatment for nontuberculous mycobacterial infections in patients with adult-onset immunodeficiency syndrome: a prospective cohort study
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Abstract
Background: Patients with nontuberculous mycobacterial (NTM) diseases associated with anti-interferon gamma autoantibodies (anti-IFN-γ auto-Abs) often experience recurrences, despite prolonged treatment, which requires intravenous anti-mycobacterial therapy. Linezolid (LZD) shows a potential as an adjunct treatment, but there is limited data on its long-term efficacy and safety. Methods: We conducted a prospective study from December 2017 to April 2022, to evaluate the efficacy of a nine-month oral LZD regimen in reducing NTM treatment failure, defined as relapse and the need for intravenous anti-mycobacterial therapy for suspected uncontrolled NTM or death as well as to determine its tolerability. Results: Among 40 adults (≥18 years) with NTM diseases and anti-IFN-γ auto-Abs treated with linezolid, 10 (25%) discontinued treatment early due to adverse events (AEs), including one death from suspected uncontrolled diseases at month seven. Of the 30 patients who completed the nine-month course, only five maintained their initial dose. The remaining 25 required dose modification: four temporarily paused treatment due to AEs, nine reduced to a half dose due to AEs, and 12 reduced their dose because of stable disease. By month nine, the cumulative incidence rates of relapse and treatment failure were 22.5 and 15.0%, respectively; consequently, 77.5% and 85.0% of patients remained free from the relapse and treatment failure. Overall, 24 patients (60%) reported a total of 31 AEs, with anemia and peripheral neuropathy being the most frequent. Conclusion: Our findings suggest that linezolid could be a valuable adjunct treatment for nontuberculous mycobacteria diseases in patients with anti-interferon gamma autoantibodies. However, close monitoring for adverse events is essential.