Efficacy and safety of contezolid in the treatment of Gram-positive bacterial infections in patients with hematological malignancies - a retrospective study

Sep 28, 2026

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Retrospective evaluation of contezolid, an oxazolidinone antibiotic, compares its safety and efficacy for treating Gram-positive bacterial infections in adult hematological patients. Patients with confirmed or suspected infections received contezolid for at least three days after chemotherapy or hematopoietic stem cell transplantation between April 2022 and June 2024. Outcomes assessed demographic and infection characteristics, microbiology, and clinical effectiveness, with adverse events including gastrointestinal symptoms as the main safety signals.

LanguageEnglish

CategoryHealthcare

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Introduction

European Journal of Clinical Microbiology & Infectious Diseases (2025) 44:3047–3055 [https://doi.org/10.1007/s10096-025-05280-9](https://doi.org/10.1007/s10096-025-05280-9) RESEARCH Efficacy and safety of contezolid in the treatment of Gram-positive bacterial infections in patients with hematological malignancies: a retrospective study Ruihua Mi1 · Luyang Chang1 · Lin Chen1 · Lin Wang1 · Yixuan Ma1 · Jia Liu1 · Dongbei Li1 · Xudong Wei1 Received: 13 June 2025 / Accepted: 8 September 2025 / Published online: 29 September 2025 © The Author(s) 2025 Abstract Purpose Contezolid, an oxazolidinone antibiotic, is recognized for its comparable antimicrobial activity to linezolid, with a distinct advantage of reduced hematological toxicity. This retrospective analysis aims to evaluate the safety and efficacy profile of contezolid in the treatment of Gram-positive bacterial infections (GPI) in hematological patients. Methods A retrospective analysis was conducted on adult hematological patients with confirmed or suspected GPI who received contezolid for at least three days following chemotherapy or hematopoietic stem cell transplantation (HSCT) at Henan Cancer Hospital between April 2022 and June 2024. Comprehensive data collection included demographic variables, treatment protocols, infection profiles, microbiological data, and clinical outcomes. Results The study included 132 patients (47.5 ± 18.0 years), 61.4% male. Treatment strategies for hematological malignancies included combination chemotherapy with targeted therapy (41.7%), chemotherapy alone (37.9%), and HSCT (20.5%) . 60.6% had febrile neutropenia. More than half of the infections occurred within one month after treatment, predominantly affecting the lungs and skin/soft tissue. Two patients had concurrent bloodstream infections (BSI) prior to receiving contezolid treatment. The median contezolid treatment was 12 days, 72.7% had it as initial treatment. The rationale for contezolid utilization includes complicated skin and soft-tissue infections (cSSTI), prior treatment failure, adverse reactions, and contraindications. Clinical effective rate was 70.6%(95% CI: 62.7% − 78.5%), with 64.4%(95% CI: 52.2% − 76.6%) in pneumonia, 74.6%(95% CI: 63.0% − 86.1%) in skin or soft tissue infections, and 69.3%(95% CI: 58.9% − 79.8%) in febrile neutropenia. Seventeen patients (12.9%) had adverse events. Twelve had new-onset/aggravated nausea or epigastric discomfort, and seven had vomiting; these may relate to contezolid. No contezolid-related hematological adverse events, optic or peripheral neuropathy were observed. Conclusions Contezolid seems promising for these patients, but large-scale prospective studies are needed for confirmation. Keywords Hematological malignancies · Gram-positive bacterial infections · Contezolid · Chemotherapy · Hematopoietic stem cell transplantation (HSCT) Ruihua Mi and Luyang Chang These authors contributed to the work equally and should be regarded as co-first authors. 􀀍 Xudong Wei [xudongwei@zzu.edu.cn](xudongwei@zzu.edu.cn) 1 The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China Introduction Patients with hematological malignancies often present with neutropenia, impaired integrity of the skin and mucous membrane barriers, and/or immunosuppression due to the pathophysiological characteristics of their diseases, as well as interventions such as receiving high-dose chemotherapy or immunosuppressive therapy [1] . This demographic has been identified as being at high risk of infection [2] . In such cases, the clinical manifestations following infection are frequently atypical, the disease often progresses rapidly, and effective treatment can be challenging to achieve [3] . Despite considerable advances in the field of hematological cancer treatment in recent years, with an increase in patient survival rates [4], infectious complications remain a significant cause of mortality amon

FAQs

What is the purpose of the study on contezolid?

To evaluate the safety and efficacy of contezolid for treating Gram-positive bacterial infections in patients with hematological malignancies.

How was the study conducted?

A retrospective analysis included adult hematological patients with confirmed or suspected infections who received contezolid for at least three days after chemotherapy or HSCT between April 2022 and June 2024.

What were the main efficacy and clinical effectiveness findings?

The overall clinical effective rate was 70.6%, with effectiveness reported across subgroups including pneumonia, skin/soft tissue infections, and febrile neutropenia.

Sep 28, 2026

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