{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:10:43Z","timestamp":1788844243204,"version":"build-2803163510"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculous meningitis (TBM) is the most severe and fatal form of tuberculosis (TB). Linezolid (Lzd), a key oxazolidinone with excellent central nervous system penetration, is widely used for TBM but is limited by significant adverse events (AEs). Contezolid (Czd), a next-generation oxazolidinone structurally optimized from Lzd, has shown promising potential. However, clinical evidence for its use in TBM remains limited to isolated case reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study of TBM patients treated with Czd- or Lzd-containing regimens. Patients were categorized into two groups: the Czd group (n=16, including 9 patients who switched from Lzd to Czd due to Lzd intolerance) and the Lzd group (n=32). We analyzed treatment outcomes, including Cerebrospinal fluid (CSF) parameters, imaging findings, and CSF culture conversion, as well as safety outcomes in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No AEs were observed in the Czd group, and hematological parameters remained stable. All Lzd-related AEs completely resolved after switching to Czd in the Lzd-to-Czd group. In the Lzd group, 68.75% experienced AEs, with 34.38% requiring dose reduction and 21.88% discontinuing treatment. Treatment outcomes were favorable in both groups: all 48 patients achieved clinical symptom improvement, with CSF Mtb culture conversion rates of 100% (Czd) vs. 93.33% (Lzd), and radiological improvement in 81.25% of patients in both groups. No significant differences were found in CSF parameter trends between the two groups (all P &amp;gt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Czd represents an effective salvage strategy for Lzd intolerance and may prevent severe AEs while maintaining efficacy comparable to Lzd. These findings support Czd as a valuable alternative for TBM treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1955690","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:26:56Z","timestamp":1788841616000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Contezolid in tuberculous meningitis: comparable efficacy and favorable safety"],"prefix":"10.3389","volume":"16","author":[{"given":"Yanmei","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Public Health Clinical Center of Chengdu, Jinjiang District, Sichuan","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Public Health Clinical Center of Chengdu, Jinjiang District, Sichuan","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianwen","family":"Quan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Public Health Clinical Center of Chengdu, Jinjiang District, Sichuan","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Public Health Clinical Center of Chengdu, Jinjiang District, Sichuan","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guihui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, Public Health Clinical Center of Chengdu, Jinjiang District, Sichuan","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1101\/2023.04.06.23288230","article-title":"Linezolid population pharmacokinetic model in plasma and cerebrospinal fluid among patients with tuberculosis meningitis","volume":"229","author":"Abdelgawad","year":"2024","journal-title":"medRxiv"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00789-23","article-title":"Contezolid can replace linezolid in a novel combination with bedaquiline and pretomanid in a murine model of tuberculosis","volume":"67","author":"Almeida","year":"2023","journal-title":"Antimicrob. 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