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다제내성결핵 환자에서 메타분석을 통한 Linezolid의 효능 및 안전성 평가

Evaluation of the Efficacy and Safety of Linezolid by Meta-analysis for Multidrug-resistant Tuberculosis Patients

김애진|채정우|정우진|성태욱|윤휘열
한국임상약학회 (Korean College Of Clinical Pharmacy)|2023.12|한국임상약학회지 (Korean Journal of Clinical Pharmacy)|제33권 제4호|pp. 278-289|DOI 10.24304/kjcp.2023.33.4.278

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키워드

meta-analysisLinezolidmultidrug-resistant tuberculosis (MDR-TB)
주제분류약학

초록

Background: Linezolid has been widely used in the treatment for multidrug-resistant tuberculosis. However, there are limitations to use it such as long treatment, because of related side effects, even adequate treatment period has been needed for remission of multidrug-resistant tuberculosis (MDR-TB). Method: The meta-analysis was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. To choose literatures, systematic literature reviews were conducted with databases of PubMed, Web of Science, and EMBASE. Results: Efficacy and safety of Linezolid were determined by 85% (95% CI=79~89%, p<0.05) in the sputum culture conversion and 55% (95% CI=45~64%, p<0.01) in side effects related to linezolid, respectively. In addition, I2 was estimated by 72%. In the subgroup analysis, efficacy and safety by dose and region were analyzed. In the subgroup analysis, compared with the linezolid dose in groups greater than 600 mg/day and less than 600 mg/day, this study showed 85% (95% CI 79~90%, p>0.05) in 206 patients and 82% (95% CI 73~89%, p<0.05) in 297 patients, respectively. Also, in the subgroup analysis, adverse effects caused by linezolid occurred more than 50% of treated patients. Conclusion: Therapeutic efficacy of linezolid for MDR-TB patients was confirmed regardless of the initial dose of linezolid, especially for sputum culture conversion and it was recommended that the dose of linezolid has been more effective below 600 mg/day. However, it should be necessary to closely monitored for safety issues since serious side effects possibly occurred by administration of long period treatment.

Abstract

Background: Linezolid has been widely used in the treatment for multidrug-resistant tuberculosis. However, there are limitations to use it such as long treatment, because of related side effects, even adequate treatment period has been needed for remission of multidrug-resistant tuberculosis (MDR-TB). Method: The meta-analysis was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. To choose literatures, systematic literature reviews were conducted with databases of PubMed, Web of Science, and EMBASE. Results: Efficacy and safety of Linezolid were determined by 85% (95% CI=79~89%, p<0.05) in the sputum culture conversion and 55% (95% CI=45~64%, p<0.01) in side effects related to linezolid, respectively. In addition, I2 was estimated by 72%. In the subgroup analysis, efficacy and safety by dose and region were analyzed. In the subgroup analysis, compared with the linezolid dose in groups greater than 600 mg/day and less than 600 mg/day, this study showed 85% (95% CI 79~90%, p>0.05) in 206 patients and 82% (95% CI 73~89%, p<0.05) in 297 patients, respectively. Also, in the subgroup analysis, adverse effects caused by linezolid occurred more than 50% of treated patients. Conclusion: Therapeutic efficacy of linezolid for MDR-TB patients was confirmed regardless of the initial dose of linezolid, especially for sputum culture conversion and it was recommended that the dose of linezolid has been more effective below 600 mg/day. However, it should be necessary to closely monitored for safety issues since serious side effects possibly occurred by administration of long period treatment.

참고문헌 (42)

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관련 논문AI추천

한국에서 다제내성결핵에 대한 경구 단기 치료 요법권용수대한내과학회 · 대한내과학회지2023 · 제98권 제4호Diagnosis and treatment of multidrug-resistant tuberculosis장종걸, 정진홍영남대학교 의과대학 · Journal of Yeungnam Medical Science2020 · 제37권 제4호Delamanid, Bedaquiline, and Linezolid Minimum Inhibitory Concentration Distributions and Resistance-related Gene Mutations in Multidrug-resistant and Extensively Drug-resistant Tuberculosis in Korea김경종, 양정성, 이승헌, 최홍조대한진단검사의학회 · Annals of Laboratory Medicine2018 · 제38권 제6호내성 결핵균의 실태 및 치료임재준대한내과학회 · 대한내과학회지2009 · 제77권 제2호Retrospective Comparison of Levofloxacin and Moxifloxacin on Multidrug-Resistant Tuberculosis Treatment Outcomes김덕겸, 김영환, 김재열, 양석철, 유철규, 윤호일, 이상민, 이재호, 이진우, 이창훈, 이춘택, 임재준, 정희순, 한성구대한내과학회 · The Korean Journal of Internal Medicine2011 · 제26권 제2호Medical Treatment of Pulmonary Multidrug-Resistant Tuberculosis심태선, 조경욱대한감염학회 · Infection and Chemotherapy2013 · 제45권 제4호

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