Li Huimin, Lu Jie, Liu Jinrong, Zhao Yuhong, Ni Xin, Zhao Shunying
From the *Beijing Children's Hospital, Capital Medical University, Beijing, China; and †Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China.
Pediatr Infect Dis J. 2016 Jun;35(6):607-10. doi: 10.1097/INF.0000000000001114.
Linezolid serves as an important component for the treatment of drug-resistant tuberculosis although there is little published data about linezolid use in children, especially in childhood tuberculous meningitis (TBM).
In this study, we retrospectively reviewed records of childhood TBM patients who started treatment between January 2012 and August 2014. A total of 86 childhood TBM patients younger than 15 years old were enrolled. Out of 86 children, 36 (41.9%) received the regimen containing linezolid.
Thirty-two (88.9%) of 36 linezolid-treated cases had favorable outcomes, and 35 (70.0%) cases were successfully treated in the control group. The frequency of favorable outcome of linezolid group was significantly higher than that of control group (P = 0.037). In addition, compared with cases with fever clearance time of <1 week, the control group had more cases with fever clearance time of 1-4 weeks (P = 0.010) and >4 weeks (P = 0.000) than linezolid group. Furthermore, there was no significant difference in the frequency of adverse events between the two regimens (P = 0.896). In addition, the patients with adverse events were more likely to have treatment failure, the P value of which was 0.008.
Our data demonstrate that linezolid improves early outcome of childhood TBM. The low frequency of linezolid-associated adverse effects highlights the promising prospects of its use for treatment of childhood TBM.
利奈唑胺是治疗耐药结核病的重要药物，然而关于儿童使用利奈唑胺，尤其是儿童结核性脑膜炎（TBM）的公开数据很少。
在本研究中，我们回顾性分析了2012年1月至2014年8月开始治疗的儿童TBM患者的记录。共纳入86例15岁以下的儿童TBM患者。86名儿童中，36例（41.9%）接受了含利奈唑胺的治疗方案。
36例接受利奈唑胺治疗的病例中，32例（88.9%）预后良好，对照组35例（70.0%）治疗成功。利奈唑胺组良好预后的频率显著高于对照组（P = 0.037）。此外，与发热清除时间<1周的病例相比，对照组发热清除时间为1 - 4周（P = 0.010）和>4周（P = 0.000）的病例比利奈唑胺组多。此外，两种治疗方案的不良事件发生率无显著差异（P = 0.896）。此外，发生不良事件的患者更易出现治疗失败，P值为0.008。
我们的数据表明，利奈唑胺可改善儿童TBM的早期预后。利奈唑胺相关不良反应的低发生率凸显了其用于治疗儿童TBM的广阔前景。
