Research Article
Linezolid Induced Peripheral Neuropathy in Multidrug Resistant Tuberculosis- A Prospective Observational Study
Maniyar A*, Chheda A, Mahto AP, Chaudhary GS, Jagiasi KA, Ojha PT, Singh RK, Nagendra S,Shah AG, Aipu BK and Bagadia HP
Department of Neurology, Grant Government Medical College and J.J. Hospital, Mumbai, Maharashtra, India
*Corresponding author: Dr. Aamna Maniyar, Department of Neurology, Grant Government Medical College and J.J.
Hospital, Mumbai, Maharashtra, India. E-mail. Id; amaniyar1991@gmail.com
Article Information: Submission: 03/02/2025; Accepted: 05/03/2025; Published: 08/03/2025
Copyright: © 2025 Maniyar A, et al. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
Abstract
Background: Linezolid is used for treatment of MDR TB and one of the common adverse effects is peripheral neuropathy. Dose modification or interruption at the onset of peripheral neuropathy can prevent the development of irreversible deficits. We aim to study the clinical features, grade the severity of linezolid induced peripheral neuropathy and effects of dose modification so as to avoid long term deficits.
Methods: MDR TB patients on linezolid treatment who developed peripheral neuropathy were studied. National Cancer Institute Neurosensory Scale was used to grade patients into mild, moderate and severe neuropathy. Mild were continued on linezolid 600 mg, moderate were reduced to 300mg and linezolid was withdrawn for severe neuropathy. Follow up was done regularly and dose modified accordingly. End result was analyzed at 18 months of TB treatment completion.
Results: 84 patients were included in the study. On presentation, 31(36.9%) patients had mild neuropathy, 33 (39.28%) moderate and 20 (23.8%) severe peripheral neuropathies. At the end of 18 months of treatment, linezolid was stopped early in 34 (40.5%) patients and dose reduction to 300mg was done in 50 (59.5%) patients. Final assessment revealed 11(13.09%) patients free from symptoms of peripheral neuropathy, 37 (44.04%) patients had mild, 22 (26.19%) had moderate and 14 (16.6%) had severe peripheral neuropathy.
Conclusion: This study highlights the importance of grading linezolid induced peripheral neuropathy and the need to provide standard guidelines for dose modification to prevent irreversible severe deficits.
Methods: MDR TB patients on linezolid treatment who developed peripheral neuropathy were studied. National Cancer Institute Neurosensory Scale was used to grade patients into mild, moderate and severe neuropathy. Mild were continued on linezolid 600 mg, moderate were reduced to 300mg and linezolid was withdrawn for severe neuropathy. Follow up was done regularly and dose modified accordingly. End result was analyzed at 18 months of TB treatment completion.
Results: 84 patients were included in the study. On presentation, 31(36.9%) patients had mild neuropathy, 33 (39.28%) moderate and 20 (23.8%) severe peripheral neuropathies. At the end of 18 months of treatment, linezolid was stopped early in 34 (40.5%) patients and dose reduction to 300mg was done in 50 (59.5%) patients. Final assessment revealed 11(13.09%) patients free from symptoms of peripheral neuropathy, 37 (44.04%) patients had mild, 22 (26.19%) had moderate and 14 (16.6%) had severe peripheral neuropathy.
Conclusion: This study highlights the importance of grading linezolid induced peripheral neuropathy and the need to provide standard guidelines for dose modification to prevent irreversible severe deficits.
Keywords:Linezolid; Peripheral Neuropathy; Multidrug Resistant TB