Multidrug-resistant tuberculosis (MDR-TB) requires effective treatment that is both manageable and safe. The BPaL/M regimen combines bedaquiline, pretomanid, linezolid, and moxifloxacin to provide a shorter treatment option, but adverse effects associated with linezolid may affect treatment management and completion.
About the Study
This retrospective analytical study examined the characteristics and comorbidities associated with linezolid adverse effects among MDR-TB patients receiving the BPaL/M regimen. The study included 103 patients treated at Haji Adam Malik General Hospital in Medan, Indonesia, during 2024.
Medical records were reviewed for hematological disorders, peripheral neuropathy, and visual disturbances occurring during treatment. Fisher’s exact test was used to assess associations between these adverse effects and patient characteristics, including age, gender, education, body mass index (BMI), diabetes mellitus (DM), and human immunodeficiency virus status.
Main Findings
Overall patient characteristics were not significantly associated with the combined occurrence of linezolid adverse effects. However, analysis of specific adverse effects identified two important associations.
Patients aged 50 years or older were more likely to experience hematological disorders. Diabetes mellitus was also significantly associated with peripheral neuropathy. These findings identify patient groups who may require closer monitoring during treatment with the BPaL/M regimen.
Why It Matters
The BPaL/M regimen offers an important shorter treatment option for MDR-TB, but adverse effects can interrupt therapy and affect treatment success. Regular hematological and neurological monitoring, particularly for older patients and those with diabetes, may support earlier detection and management of linezolid-related complications.
Citation
Tako FW, Sinaga BYM, Harahap J, Daulay RS, Siregar J, Samodra YL. Age and diabetes mellitus associated with hematological disorders and peripheral neuropathy in MDR-TB patients treated with the BPaL/M regimen. Jurnal Respirasi. 2025;11(3):241-249. https://doi.org/10.20473/jr.v11-i.3.2025.241-249