Prolonged use of tedizolid in a pulmonary non-tuberculous mycobacterial infection after linezolid-induced toxicity
Yuste JR (1,2), Bertó J (3), Del Pozo JL (4,5), Leiva J (5).
(1) Division of Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain
(2) Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain.
(3) Respiratory Medicine Service, Clinica Universidad de Navarra, Pamplona, Spain.
(4) Division of Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain.
(5) Department of Clinical Microbiology, Clinica Universidad de Navarra, Pamplona, Spain.
Tedizolid phosphate is a new and potent oxazolidinone prodrug that was recently approved for the treatment of acute bacterial skin and skin structure infections caused by susceptible microorganisms. Furthermore, tedizolid has proven to be active against Mycobacterium tuberculosis1 and non-tuberculous mycobacteria, such as Mycobacterium abscessus.2
We present the first case of prolonged treatment with tedizolid after haematological toxicity and gastrointestinal intolerance with linezolid in a patient with pulmonary non-tuberculous mycobacterial infection.
A male patient in his seventies was diagnosed with a pulmonary infection caused by Mycobacterium avium intracellulare and Mycobacterium kansasii (American Thoracic Society/IDSA criteria). The antimicrobial susceptibility tests revealed that only ethambutol (MIC, 0.125 and 0.25 mg/L, respectively), clarithromycin (MIC, 0.5 and 0.008 mg/L), amikacin (MIC, 8 and 0.25 mg/L), co-trimoxazole (MIC, 0.032 and 0.001 mg/L) and oxazolidinones were active against both non-tuberculous mycobacteria. The therapeutic options available for our patient were limited to azithromycin, ethambutol and oxazolidinones given his previous gastrointestinal intolerance to clarithromycin and episode of renal toxicity with co-trimoxazole.
CITATION J Antimicrob Chemother. 2016 Dec 20. pii: dkw484. doi: 10.1093/jac/dkw484