Moxifloxacin in multidrug-resistant tuberculosis: is there any indication for therapeutic drug monitoring?: Table 1–

Manika, Κaterina; Chatzika, Kalliopi; Zarogoulidis, Konstantinos; Kioumis, Ioannis

doi:10.1183/09031936.00202411

Cited by 14 publications

(14 citation statements)

References 11 publications

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“…Rapid molecular drug resistance testing should therefore include these mutations. Encouragingly, however, the reduced in vitro growth rates of mutants in 2 g/ml moxifloxacin suggest that the growth of these mutants in patients is likely to be suppressed at attainable moxifloxacin serum concentrations (5,6,10,14,15). This supports a previous meta-analysis, which showed that moxifloxacin was still effective for the treatment of XDR-TB despite the presence of fluoroquinolone resistance (21).…”

supporting

confidence: 76%

“…Since the use of moxifloxacin for the treatment of TB is not yet widespread, it is not clear which mutations could emerge. Mutations that facilitate increased moxifloxacin resistance (MICs of Ն2 g/ml) have clinical relevance, given that the current standard dose leads to serum concentrations of 1.3 to 6.9 g/ml (5,6,10,14,15). Knowledge of such mutations is critical for optimizing rapid molecular methods for detecting moxifloxacin resistance.…”

mentioning

confidence: 99%

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Moxifloxacin Retains Antimycobacterial Activity in the Presence of gyrA Mutations

McGrath

Pittius

Sirgel

et al. 2014

Antimicrob Agents Chemother

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Moxifloxacin-resistant Mycobacterium tuberculosis mutants were selected in vitro using different concentrations of moxifloxacin. gyrA mutations at codons 88 and 94 were associated with resistance (defined as an MIC of >2 g/ml) (P < 0.0001 and P ‫؍‬ 0.0053, respectively). Despite the presence of gyrA mutations, moxifloxacin significantly impedes bacterial growth, supporting its use for the treatment of ofloxacin-resistant M. tuberculosis.

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supporting

confidence: 76%

mentioning

confidence: 99%

Moxifloxacin Retains Antimycobacterial Activity in the Presence of gyrA Mutations

McGrath

Pittius

Sirgel

et al. 2014

Antimicrob Agents Chemother

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“…The conclusion was that TDM of linezolid might improve safety outcomes associated with long-term treatment in adult patients, 11 whereas TDM of moxifloxacin could have a significant impact on clinical decisions, particularly in patients with XDR-TB. 12 Furthermore, individualized dosing of linezolid 10 or moxifloxacin 13 based on limited sampling was determined to be feasible. According to the WHO guidelines, 8 at least four drugs should be used for MDR-TB patients.…”

Section: Pilot Pharmacokinetic Analysismentioning

confidence: 99%

“…6,27 -30 However, in terms of second-line TB drugs, only a limited number of studies have been performed for some drugs. 6,10,12,13 To perform the pharmacokinetic studies and TDM effectively, validated methods for quantifying plasma drug concentrations are mandatory. The goal of this study was to set up a simple, rapid, multiplexed and validated UPLC-MS/MS method.…”

Section: Pilot Pharmacokinetic Analysismentioning

confidence: 99%

Method for simultaneous analysis of nine second-line anti-tuberculosis drugs using UPLC-MS/MS

Han¹,

Jun²,

Lee³

et al. 2013

Journal of Antimicrobial Chemotherapy

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Objectives: Therapeutic drug monitoring (TDM) of anti-tuberculosis (TB) drugs is beneficial for patients responding slowly to treatment and those with multidrug-resistant TB. We used ultra-performance liquid chromatographytandem mass spectrometry (UPLC-MS/MS) to develop a rapid method for simultaneously measuring the blood concentrations of nine second-line anti-TB drugs: streptomycin, kanamycin, clarithromycin, cycloserine, moxifloxacin, levofloxacin, para-aminosalicylic acid, prothionamide and linezolid.Methods: Serum samples were extracted with acidified methanol and neutralized with NaOH. A Waters Acquity HSS T3 column and gradients of ammonium formate and acetonitrile in 0.1% formic acid were used for UPLC separation. Drug concentrations were determined by multiple reaction monitoring in positive ion mode, and assay performance was evaluated. We applied this method to TDM, analysing random serum samples from 85 patients treated with second-line drugs.Results: Sample preparation using acidified methanol extraction followed by neutralization yielded good recovery and ionization efficiency, with chromatographic separation achieved within 3 min per sample. Within-run and between-run precisions were 1.7% -7.5% and 1.7% -12.4%, respectively, at concentrations representing low and high levels for the nine drugs. Lower limits of detection and quantification were 0.025-0.5 and 0.25 -5.0 mg/mL, respectively. Linearity was acceptable at five concentrations for each drug. No ion suppression was observed at the retention time for most compounds, except for streptomycin, kanamycin and cycloserine, which were eluted close to the void volume of the column. In a limited pilot study, all quantifiable human samples had values within the validated assay ranges. Conclusions:The performance of our MS/MS detection technique was generally acceptable. The method provided rapid, sensitive and reproducible quantification of nine second-line anti-TB drugs and should facilitate drug monitoring during treatment.

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“…Aktualnie -zgodnie ze wskazaniami WHO -do leczenia chorych na MDR-TB rekomendowane są lewofloksacyna i moksyfloksacyna [64,66,70,71]. Potwierdza to w pełni metaanaliza 6465 przypadków chorych na gruźlicę, w której porównywano skuteczność m.in.…”

Section: Fluorochinolony W Leczeniu Gruźlicyunclassified

Lewofloksacyna i moksyfloksacyna w leczeniu zakażeń bakteryjnych

Płusa¹

2016

Forum Zakażeń

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STRESZCZENIE: Klasyfikacja fluorochinolonów została oparta na spektrum mikrobiologicznym i cechach farmakokinetycznych kolejno wprowadzanych preparatów, które charakteryzowały się lepszymi właściwościami farmakodynamicznymi, w tym znaczną penetracją do wnę-trza makrofagów i miejsca toczącego się procesu zapalnego. Przeprowadzona porównaw-cza analiza lewofloksacyny i moksyfloksacyny wskazuje na ich skuteczność kliniczną w kontrolowaniu zakażeń układowych zarówno w obrębie układu oddechowego, jak i moczowego, zwłaszcza w przypadku lewofloksacyny. Z tego powodu obydwa preparaty znalazły się w obowiązujących obecnie rekomendacjach postępowania w zakażeniach. Narastająca oporność na antybiotyki zmusza do ich racjonalnego stosowania -zgodnego ze światowymi wytycznymi.SŁOWA KLUCZOWE: lewofloksacyna, moksyfloksacyna, zakażenie ABSTRACT: Classification of fluoroquinolones is based on the spectrum of microbiological and pharmacokinetic characteristics in turn introduced preparations, which were characterized by improved pharmacodynamic properties, including significant penetration into the macrophages and inflammatory tissue. Conducted a comparative analysis of levofloxacin and moxifloxacin indicates clinically effective in controlling systemic infections both within the respiratory tract and urinary tract, particularly levofloxacin. For this reason, two products had been included in the recommendations of conduct infections developed in recent years. Increasing antibiotic resistance forces to their rational use -in accordance with international guidelines. WSTĘP Wskazaniem do stosowania antybiotyków są stany zapalne wywołane przez drobnoustroje. W zależności od rodzaju patogenu, jego aktywności i wrażliwości na podawany preparat o działaniu hamującym rozwój lub zabijającym bakterie, uzyskuje się odpowiedni efekt kliniczny. Najważniej-szym elementem tego postępowania, poza charakterystyką patogenu, są cechy farmakokinetyczne stosowanego antybiotyku, w tym: jego spektrum działania, stopień penetracji do miejsca toczącego się procesu zapalnego, wykazywane interakcje z innymi cząsteczkami oraz bezpieczeństwo dla chorego [1]. Posiadana wiedza w tym zakresie jest bardzo pomocna przy podejmowaniu decyzji terapeutycznych. KLASYFIKACJA FLUOROCHINOLONÓWChinolony należą do czynników przeciwbakteryjnych zsyntetyzowanych w latach 60. XX wieku w wyniku modyfikacji podstawowej dwupierścieniowej chemicznej struktury. Współczesna klasyfikacja fluorochinolonów jest oparta na spektrum mikrobiologicznym i cechach farmakokinetycznych poszczególnych preparatów. Należy podkreślić, Artyku jest dost pny na zasadzie dozwolonego u ytku osobistego. Dalsze rozpowszechnianie (w tym umieszczanie w sieci) jest zabronione i stanowi powa ne naruszenie przepisów prawa autorskiego oraz grozi sankcjami prawnymi.

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Moxifloxacin in multidrug-resistant tuberculosis: is there any indication for therapeutic drug monitoring?: Table 1–

Cited by 14 publications

References 11 publications

Moxifloxacin Retains Antimycobacterial Activity in the Presence of gyrA Mutations

Moxifloxacin Retains Antimycobacterial Activity in the Presence of gyrA Mutations

Method for simultaneous analysis of nine second-line anti-tuberculosis drugs using UPLC-MS/MS

Lewofloksacyna i moksyfloksacyna w leczeniu zakażeń bakteryjnych

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