Safety and Tolerability of More than Six Days of Tedizolid Treatment.

Tedizolid has demonstrated its efficacy and safety in clinical trials; however, data concerning its tolerability in long-term treatments are scarce. The aim of the study was to assess the indications and to describe the long-term safety profile of tedizolid. A multicentric retrospective study of patients who received tedizolid for more than 6 days was conducted. Adverse events (AEs) were identified from patients' medical records and laboratory data. The World Health Organization causality categories were used to discern AEs that were probably associated with tedizolid. Eighty-one patients, treated with tedizolid 200 mg once daily for a median (interquartile range [IQR]) duration of 28 (14 to 59) days, were included; 36 (44.4%) had previously received linezolid. The most common reasons for selecting tedizolid were to avoid linezolid potential toxicities or interactions (53.1%) or due to previous linezolid-related toxicities (27.2%). The most common indications were off-label, including prosthetic joint infections, osteomyelitis, and respiratory infections (77.8%). Overall, 9/81 patients (11.1%) experienced a probably associated AE. Two patients (2.5%) developed gastrointestinal disorders, 1 (1.2%) developed anemia, and 6 developed thrombocytopenia (7.4%) after a median (IQR) duration of treatment of 26.5 (17 to 58.5) days. Four (5%) patients discontinued tedizolid due to AEs. Among 23 patients with chronic renal failure (CRF), the rate of myelotoxicity was 17.4%, and only 8.7% had to stop tedizolid; 20 out of 22 with previous linezolid-associated toxicity had no AE. Long-term tedizolid treatments had good tolerance with rates of gastrointestinal AE and hematological toxicity lower than those reported with linezolid, particularly in patients with CRF and in those with a history of linezolid-associated toxicity.

Uso del QuantiFERON-TB Gold en la consulta de Medicina del Trabajo en un medio hospitalario. 8 años de experiencia / Utility of QuantiFERON-TB Gold in screening of health care workers. 8 years of experience

Objetivo: Valorar la eficiencia del uso del QuantiFERON-TB Gold (QTFGIT) en el diagnóstico de infección tuberculosa latente. Material y métodos: En la consulta de Medicina del Trabajo de un medio hospitalario, se comparan los resultados del QTF-GIT en trabajadores con prueba de la tuberculina (PT) positiva entre los años 2007-2014. Además, se realiza un estudio de validación diagnóstica para la PT en los puntos de corte de 10 y 5mm. Resultados: Se estudiaron 2.085 pacientes y se realizaron 2.679PT 182 (+), 2435 (-). Se realizaron 1.623 QTF-GIT; 132 (+), 1.486 (-). Tras una PT positiva el 61,4% QTF-GIT presentaron un resultado negativos (p<0.001). La PT, con puntos de corte en 10 y 5mm, muestra una sensibilidad del 88% y 100% (p<0.001) una especificidad del 35% y 3% (p<0.001) respectivamente. Conclusiones: La PT en la consulta de Medicina del Trabajo está justificada al tratarse de una prueba diagnóstica con alta sensibilidad, pero al generar un gran número de falsos positivos, precisa posteriormente de una prueba con una alta especificidad como el QTF-+GIT para evitar la quimioprofilaxis innecesaria (AU)

Objective: To evaluate the efficiency of QuantiFERON-TB Gold (QFT-GIT) to diagnose latent tuberculosis infection. Methods: In an Occupational Medicine consultation, we analysed the results of QFT-GIT in hospital workers with positive tuberculin skin test (TST) between years 2007-2014. Also a validation study was performed for the TST in the cut offs considered as 10 and 5 mm. Results: 2,085 patients were studied. We performed 2,679 TST 182 (+), 2,435 (-). 1,623 QTF-GIT were done; 132 (+), 1,486 (-). After a positive TST 61.4% QFTGIT showed a negative result (p<0.001). The TST, with 10 or 5 mm considered as cut-off, showed a sensitivity of 88% and 100% (p<0.001) and a specificity of 35% and 3% (p<0.001) respectively. Conclusions: The use of TST in Occupational Medicine is justified as it is a diagnostic test with high sensitivity, but as it generates a large number of false positive, confirmation with a higher specificity test, such as the QFT-GIT is required to avoid unnecessary chemoprophylaxis (AU)