{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:34:12Z","timestamp":1788878052967,"version":"build-2803163510"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"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. Med."],"abstract":"<jats:p>Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis (TB) and the most severe form of extrapulmonary TB. It often presents with non-specific symptoms initially and has a high mortality and disability rate. With good central nervous system penetration, linezolid is recommended for treating drug-resistant, severe, or refractory tuberculous meningitis in China. Despite the benefits of linezolid on TBM treatment, the adverse effects of long-term therapy, such as myelosuppression, peripheral neuritis, and optic neuritis, are notable and can be severe and even life-threatening, leading to discontinuation and compromising treatment expectations. Contezolid is a novel oxazolidinone antibacterial agent approved by the National Medical Products Administration of China in 2021, which has a more favorable safety profile than linezolid in terms of myelosuppression and monoamine oxidase inhibition. Here we first report a case of TBM in a patient who was intolerant to antituberculosis treatment with linezolid and achieved good efficacy and safety results after the compassionate use of contezolid. Given the widespread use of linezolid in TB treatment and the potential risks for long-term use, multi-center prospective controlled clinical trials in TB and TBM patients are needed to investigate the appropriate use of contezolid further.<\/jats:p>","DOI":"10.3389\/fmed.2023.1224179","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T07:59:39Z","timestamp":1697702379000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Case report: Successful treatment with contezolid in a patient with tuberculous meningitis who was intolerant to linezolid"],"prefix":"10.3389","volume":"10","author":[{"given":"Zhe","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guichuan","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linchuan","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianzhi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1097\/QCO.0000000000000648","article-title":"Tuberculous meningitis: where to from Here?","volume":"33","author":"Donovan","year":"2020","journal-title":"Curr Opin Infect Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"988","DOI":"10.3760\/cma.j.cn112147-20220320-00220","article-title":"Consensus on linezolid in the treatment of tuberculosis(2022 update)","volume":"45","year":"2022","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi"},{"key":"ref3","year":"2019"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"733","DOI":"10.3760\/cma.j.issn.1001-0939.2019.10.006","article-title":"Chinese expert consensus on multidrug-resistant tuberculosis and rifampicin-resistant tuberculosis treatment","volume":"42","year":"2019","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.5588\/ijtld.18.0822","article-title":"Linezolid for the treatment of extensively drug-resistant tuberculosis: a systematic review and Meta-analysis","volume":"23","author":"Lifan","year":"2019","journal-title":"Int J Tuberc Lung Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"4487","DOI":"10.1021\/jm401931e","article-title":"New potent antibacterial Oxazolidinone (Mrx-I) with an improved class safety profile","volume":"57","author":"Gordeev","year":"2014","journal-title":"J Med Chem"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"38","DOI":"10.2174\/1574884714666190121154813","article-title":"Drug-induced peripheral neuropathy: a narrative review","volume":"15","author":"Jones","year":"2020","journal-title":"Curr Clin Pharmacol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1792","DOI":"10.3201\/eid2608.191499","article-title":"Linezolid-associated neurologic adverse events in patients with multidrug-resistant tuberculosis, France","volume":"26","author":"Jaspard","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"99","DOI":"10.5582\/ddt.2022.01025","article-title":"Prospects of Contezolid (Mrx-I) against multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis","volume":"16","author":"Yang","year":"2022","journal-title":"Drug Discov Ther"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0088921","DOI":"10.1128\/AAC.00889-21","article-title":"A novel Oxazolidinone, Contezolid (Mrx-I), expresses anti-Mycobacterium Abscessus activity in vitro","volume":"65","author":"Guo","year":"2021","journal-title":"Antimicrob Agents Chemother"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac492.1326","article-title":"1696. Comparison of in vitro activities of linezolid and Contezolid against clinical Nocardia isolates","volume":"9","author":"Wei","year":"2022","journal-title":"Open Forum Infect Dis"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"729900","DOI":"10.3389\/fmicb.2021.729900","article-title":"In vitro activity of Contezolid against methicillin-resistant Staphylococcus Aureus, vancomycin-resistant Enterococcus, and strains with linezolid resistance genes from China","volume":"12","author":"Wang","year":"2021","journal-title":"Front Microbiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e02181","DOI":"10.1128\/AAC.02181-16","article-title":"Single- and multiple-dose study to determine the safety, tolerability, pharmacokinetics, and food effect of Oral Mrx-I versus linezolid in healthy adult subjects","volume":"61","author":"Eckburg","year":"2017","journal-title":"Antimicrob Agents Chemother"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1016\/j.clinthera.2019.04.025","article-title":"Tolerability and pharmacokinetics of Contezolid at therapeutic and Supratherapeutic doses in healthy Chinese subjects, and assessment of Contezolid dosing regimens based on pharmacokinetic\/Pharmacodynamic analysis","volume":"41","author":"Wu","year":"2019","journal-title":"Clin Ther"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e02158","DOI":"10.1128\/AAC.02158-19","article-title":"Evaluation of the effect of Contezolid (Mrx-I) on the corrected Qt interval in a randomized, double-blind, placebo- and positive-controlled crossover study in healthy Chinese volunteers","volume":"64","author":"Wu","year":"2020","journal-title":"Antimicrob Agents Chemother"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1762","DOI":"10.1093\/jac\/dkac073","article-title":"A phase iii multicentre, randomized, double-blind trial to evaluate the efficacy and safety of Oral Contezolid versus linezolid in adults with complicated skin and soft tissue infections","volume":"77","author":"Zhao","year":"2022","journal-title":"J Antimicrob Chemother"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e00493","DOI":"10.1128\/AAC.00493-18","article-title":"In vitro and in vivo activities of Contezolid (Mrx-I) against Mycobacterium Tuberculosis","volume":"62","author":"Shoen","year":"2018","journal-title":"Antimicrob Agents Chemother"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e0165522","DOI":"10.1128\/aac.01655-22","article-title":"Side-by-side profiling of Oxazolidinones to estimate the therapeutic window against mycobacterial infections","volume":"67","author":"Negatu","year":"2023","journal-title":"Antimicrob Agents Chemother"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.2147\/IDR.S401533","article-title":"Sequential therapy of linezolid and Contezolid to treat vancomycin-resistant Enterococcus Faecium pneumonia in a centenarian patient: case report","volume":"16","author":"Chen","year":"2023","journal-title":"Infect Drug Resist"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1224179\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T07:59:46Z","timestamp":1697702386000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1224179\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,19]]},"references-count":19,"alternative-id":["10.3389\/fmed.2023.1224179"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1224179","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,19]]},"article-number":"1224179"}}