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April 23, 2026BMC Infectious Diseases0 citationsOpen Access

Towards precision dosing of contezolid: moderate hepatic impairment increases plasma concentration of contezolid in anti-tuberculosis treatment

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HLHong LuCentral South UniversityMFManjiao FuCentral South UniversityQSQunzhi ShiCentral South University

Key Points

  • This research aims to characterize the plasma concentration profile of contezolid and identify factors influencing its levels in tuberculosis patients.
  • Conducted a prospective observational study on tuberculosis patients receiving contezolid (800 mg every 12 h).
  • Performed therapeutic drug monitoring to measure steady-state trough plasma concentrations (Cmin) of contezolid.
  • Analyzed the influence of demographic and laboratory factors on Cmin of contezolid, particularly liver function.
  • Cmin of contezolid ranged from 0.11 mg/L to 18.01 mg/L, showing significant interindividual variability.
  • Moderate hepatic impairment significantly increased Cmin from 2.98 ± 4.19 mg/L to 9.69 ± 4.95 mg/L.
  • Total bilirubin levels were identified as the primary factor influencing Cmin, while age, sex, albumin, aspartate aminotransferase, and kidney function showed no significant impact.

Abstract

Contezolid is a novel oxazolidinone antibiotic with potent antimicrobial activity against Mycobacterium tuberculosis. To date, the plasma concentration profile of contezolid and its influencing factors remain poorly characterized. This prospective observational study included patients who were diagnosed as tuberculosis and received contezolid (800 mg every 12 h) between July 2024 and October 2025. All patients underwent therapeutic drug monitoring to obtain steady-state trough plasma concentrations (Cmin) of contezolid. Demographic characteristics and laboratory examinations were recorded. The factors associated with Cmin of contezolid were explored. A total of 25 patients were included in the study. The Cmin of contezolid ranged from 0.11 mg/L to 18.01 mg/L. Total bilirubin was identified as the key factor influencing the Cmin of contezolid while no significant associations were observed with age, sex, albumin, aspartate aminotransferase, or estimated glomerular filtration rate. Furthermore, patients were grouped by their liver function, and the result revealed that moderate hepatic impairment induced a significant increase of Cmin from 2.98 ± 4.19 mg/L to 9.69 ± 4.95 mg/L. The Cmin of contezolid exhibits substantial interindividual variability. Close monitoring is therefore recommended in patients with hepatic impairment to guide potential dose adjustments.

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Cite This Study

Lu et al. (2026) studied this question.

synapsesocial.com/papers/69e9b6aa85696592c86eb086https://doi.org/10.1186/s12879-026-13353-z
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