Use of linezolid and bedaquiline in patients with pulmonary tuberculosis in the postoperative period

Objective: to assess the effectiveness of chemotherapy regimens for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) with the inclusion of linezolid (Lzd) and bedaquiline (Bq) in patients who underwent a surgery for pulmonary TB. Materials and Methods. A non-randomized continuous single-center retrospective clinical trial based on 154 patients who were operated for drug-resistant pulmonary TB at the National Medical Research Center for Phthisiology and Infectious Diseases, Moscow, Russia, from 2018 through 2023. A comparative analysis of the effectiveness of chemotherapy regimens (depending on the inclusion of new anti-tuberculosis drugs ATDs) was performed. Results. The proportions of adverse effects of ATDs in both study groups without taking into account the use of Lzd and Bq were similar: in 24.1% (n=21/87) of cases in Group 1 and in 25.4% (n=17/67) of patients in Group 2. The inclusion of Lzd and Bq in the postoperative chemotherapy regimen (Group 1) significantly reduced the duration of the treatment course to 38.5±2.1 weeks vs. 44.6±2.2 weeks in Group 2. Thus, the favorable outcome occurred 6.1 weeks earlier with the inclusion of Lzd and Bq (p=0.041). Adverse effects of ATDs were observed in 24.1% of patients treated with Lzd and Bq. Conclusion. The inclusion of Lzd and Bq in the MDR-TB and XDR-TB chemotherapy regimens makes it possible to reduce the total duration of the treatment course until a favorable outcome is observed.