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Dolutegravir monotherapy in HIV-infected naive patients with an HIV-RNA load <100 000 copies/mL: a medium-term follow-up

linezolid before introduction of tedizolid. Interestingly, in two cases, though we immediately introduced tedizolid after linezolid interruption, we noted the rapid correction of myelotoxicity and no subsequent new toxicity despite a prolonged use of tedizolid (9 and 12 weeks, respectively) for two patients. The myelotoxicity of oxazolidinones is not well explained, but seems to be linked to mitochondrial toxicity. Since tedizolid exhibits a greater, but shorter, inhibition of mitochondrial protein synthesis than linezolid, this, combined with a lower total daily dose (200 mg daily versus 1200 mg daily), could explain the noticeable absence of myelotoxicity for tedizolid at current doses. Indeed, a recent study in healthy subjects has shown that higher daily doses of tedizolid (300 and 400 mg daily) seem to induce thrombocytopenia as frequently as linezolid. Finally, microbiological cure was obtained with tedizolid for the two infections that were documented. Other works will have to confirm the long-term haematological safety of tedizolid, but we believe there is no need for any washout period after linezolid-induced myelotoxicity, as demonstrated in two of our three patients.