{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:33:57Z","timestamp":1788878037692,"version":"build-2803163510"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"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. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Linezolid (Lzd) is a cornerstone for drug-resistant and complex tuberculosis (TB), but its utility is severely limited by hematological and neurological toxicities. Contezolid (Czd), a novel oxazolidinone, offers a potentially safer profile. However, real-world evidence remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the real-world effectiveness and safety of Czd in patients with complex TB, focusing on its role in managing Lzd toxicity through two distinct strategies: salvage therapy for Lzd-intolerant patients and proactive initiation in patients at high risk for Lzd-related adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study of TB patients treated with Czd-containing regimens. Patients were categorized into two groups: Group A switched from Lzd to Czd due to Lzd intolerance; Group B received Czd as initial treatment due to high risk of Lzd toxicity. Treatment outcomes, adverse events (AEs), and resolution of Lzd-related AEs after switching to Czd were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 31 patients in Group A experienced Lzd-related AEs (100%), with median onset of 45\u202fdays. Anemia was the most common AE (90%). After switching to Czd, significant recovery occurred in all AEs, with 52% achieving complete AE resolution. In Group B, no significant changes were observed. Treatment outcomes were excellent in both groups, with 100% clinical improvement and high sputum culture conversion rates (90% vs. 88%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Czd represented an effective salvage strategy for Lzd intolerance, significantly improving toxicity, ensuring therapeutic continuity, and suggesting preliminary evidence of maintained efficacy in complex TB. For patients at high risk of Lzd-related AEs, selecting Czd as initial therapy may prevent severe toxicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1852016","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:44:59Z","timestamp":1784267099000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From linezolid to contezolid: a strategy for safe continuation of therapy in complex tuberculosis"],"prefix":"10.3389","volume":"17","author":[{"given":"Fei","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Public Health Clinical Center of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Public Health Clinical Center of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Public Health Clinical Center of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Public Health Clinical Center of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmei","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Public Health Clinical Center of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guihui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, Public Health Clinical Center of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"11786361221099878","DOI":"10.1177\/11786361221099878","article-title":"Recent progress in the development of novel mycobacterium cell wall inhibitor to combat drug-resistant tuberculosis","volume":"15","author":"Belete","year":"2022","journal-title":"Microbiol. Insights."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/s40121-025-01256-6","article-title":"The structure, properties, and clinical utility of contezolid for antituberculosis: a narrative review","volume":"15","author":"Chen","year":"2026","journal-title":"Infect. Dis. Ther."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1186\/s12879-025-10874-x","article-title":"Clinical efficacy of linezolid in the treatment of tuberculous meningitis: a retrospective analysis and literature review","volume":"25","author":"Fei","year":"2025","journal-title":"BMC Infect. Dis."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"107302","DOI":"10.1016\/j.ijantimicag.2024.107302","article-title":"Increased risk of adverse drug reactions by higher linezolid dose per weight in multidrug-resistant tuberculosis","volume":"64","author":"Kuhlin","year":"2024","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1186\/s40001-025-03011-6","article-title":"Adverse effects of linezolid in the treatment of drug-resistant tuberculosis combined with diabetic peripheral neuropathy","volume":"30","author":"Li","year":"2025","journal-title":"Eur. J. Med. Res."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3390\/medsci14010003","article-title":"Adverse drug reaction to linezolid in drug-resistant tuberculosis: a systematic review","volume":"14","author":"Oktaviani","year":"2025","journal-title":"Med. Sci."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1265923","DOI":"10.3389\/fmed.2023.1265923","article-title":"Tuberculosis patients with special clinical conditions treated with contezolid: three case reports and a literature review","volume":"10","author":"Wang","year":"2023","journal-title":"Front. Med. (Lausanne)."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"6237","DOI":"10.2147\/IDR.S425743","article-title":"Clinical utility of contezolid-containing regimens in 25 cases of linezolid-intolerable tuberculosis patients","volume":"16","author":"Wang","year":"2023","journal-title":"Infect. Drug. Resist."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"3307","DOI":"10.2147\/IDR.S516991","article-title":"Safety and tolerability of contezolid versus linezolid for short-term treatment of rifampicin-resistant pulmonary tuberculosis: a randomized controlled study","volume":"18","author":"Wang","year":"2025","journal-title":"Infect. Drug. Resist."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s40268-025-00504-x","article-title":"Safety evaluation of contezolid (MRX-I) versus linezolid in Sprague-dawley rats","volume":"25","author":"Wei","year":"2025","journal-title":"Drugs. R. D."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"3491","DOI":"10.2147\/IDR.S469509","article-title":"Contezolid for the treatment of drug-resistant tuberculosis in China: a clinical case series","volume":"17","author":"Xiong","year":"2024","journal-title":"Infect. Drug Resist."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"96","DOI":"10.5582\/ddt.2022.01024","article-title":"Linezolid for patients with multidrug-resistant tuberculosis\/extensively drug-resistant tuberculosis in China","volume":"16","author":"Zhang","year":"2022","journal-title":"Drug Discov. Ther."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1852016\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:45:00Z","timestamp":1784267100000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1852016\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":12,"alternative-id":["10.3389\/fmicb.2026.1852016"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2026.1852016","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]},"article-number":"1852016"}}