Background

Tuberculosis is the leading cause of death in South Africa, and the country has a growing epidemic of drug-resistant tuberculosis (DR-TB). Every year, approximately 15,000 people are diagnosed with multi-drug resistant TB (MDR-TB), with a substantial proportion of these found to have more extensively drug resistant TB (XDR-TB).

MDR-TB is resistant to isoniazid and rifampicin—the two most commonly used anti-TB drugs—while XDR-TB is also resistant to at least half of the second-line medicines used to treat MDR-TB.

Less than half of the patients diagnosed with DR-TB in South Africa are started on treatment. Of those who do start on treatment, only about half of those patients with MDR-TB, and less than 20% of patients with XDR-TB are cured.

Treatment Options

Treatment consists of up to 20 pills a day, for at least two years, with painful injections for the first six months of treatment and many patients suffering terrible side effects. Treatment must consist of multiple drugs as part of a regimen, but options of drugs to include in regimens for XDR‐TB patients are extremely limited.

Linezolid

Linezolid is a good treatment option which could be used effectively within a multi‐drug regimen for DR‐TB patients in whom standard second‐line TB treatment is unlikely to provide an adequate chance of a cure. While not originally developed to treat TB, a number of clinical studies have found the antibiotic to be effective against DR‐TB.