Therapeutic Drug Monitoring for Slow Response to Tuberculosis Treatment in a State Control Program, Virginia, USA

Heysell, Scott K; Moore, Jane L.; Keller, Suzanne; Houpt, Eric R.

doi:10.3201/eid1610.100374

Cited by 144 publications

(121 citation statements)

References 27 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…A near inverse correlation was obtained in diabetic patients (Pearson's correlation=-0.402, P value=0.001); however such a correlation was not observed in non-diabetic pulmonary tuberculosis patients suggesting that the drug absorption is disfavoured only under hyperglycemic conditions and linear relationship does not exist between blood glucose and rifampicin Cmax (Pearson's correlation=0.006, P Value=0.962). This is similar to the study reported by Nijland et al (2006), Heysell et al (2010) and Heysell et al (2013) [12,[16][17]. The RBS vs Cmax correlation plot of non-diabetic and diabetic PTB patients is shown in fig.…”

Section: Fig 2: Distribution Based On Cat Regimensupporting

confidence: 80%

Effect of Diabetes Mellitus on Rifampicin Peak Serum Concentration

Saranya

Parthasarathy

Hariprasad

et al. 2016

Int J Pharm Pharm Sci

View full text Add to dashboard Cite

Objective: To comparatively analyze the peak serum concentration (Cmax) of rifampicin and to determine the incidence of decreased Cmax between diabetic and non-diabetic adult pulmonary tuberculosis patients. Methods:A cross-sectional observational study was carried out in the chest and tuberculosis (TB) department of a tertiary care hospital after the approval of the institutional ethics committee. Five millilitre (ml) of blood was withdrawn by venipuncture from each patient at a time point of 2 h post dose administration at steady state concentration (Css Results:The mean (Standard Deviation (SD)) age of the study population was 46.8 (14.2) years. The mean serum C ). The separated serum was centrifuged at a rate of 3500 rotations per minute (rpm) for a period of fifteen minutes and the resultant serum was stored at-70 ° C until analysis. Estimation of rifampicin concentration was carried out in Thermo TSQ Ultra (MS/MS) with Shimadzu 20 AD UFLC LC-MS. max of rifampicin was significantly less in diabetic patients with pulmonary tuberculosis (p=0.0305). Statistically, a significant difference in the incidence of a decrease in Cmax was found between diabetic and non-diabetic patients (p=0.0335). Diabetes mellitus was found to be the predominant factor that affects rifampicin Cmax Conclusion: In this study, an effect of diabetes mellitus (DM) on the peak serum concentration of rifampicin was observed. Patients with hyperglycemia levels had significantly reduced levels of rifampicin serum concentrations, thus showing an inversely proportional relationship between blood glucose and rifampicin serum levels..

show abstract

Section: Fig 2: Distribution Based On Cat Regimensupporting

confidence: 80%

Effect of Diabetes Mellitus on Rifampicin Peak Serum Concentration

Saranya

Parthasarathy

Hariprasad

et al. 2016

Int J Pharm Pharm Sci

View full text Add to dashboard Cite

show abstract

“…TDM, although not yet popular among TB specialists, is well known in clinical pharmacology [20][21][22]. It is based on the collection of blood samples and allows the ex vivo evaluation of blood-drug concentration, and, consequently, of its potential quantitative effect on the pharmacological target.…”

mentioning

confidence: 99%

Therapeutic drug management: is it the future of multidrug-resistant tuberculosis treatment?

et al. 2013

View full text Add to dashboard Cite

@ERSpublications TDM can be helpful for multidrug-resistant tuberculosis therapeutic decisions. DBS can bypass logistical issues http://ow.ly/otsFp Multidrug-and extensively drug-resistant (M/XDR) tuberculosis (TB) are emerging public health concerns [1,2]. In 2011, the World Health Organization (WHO) estimated 12 million prevalent cases of TB globally, which is equivalent to 170 cases per 100 000 population, out of these an estimated 630 000 cases were affected by MDR Mycobacterium tuberculosis strains [3]. Among the newly diagnosed patients ,3.7% were infected by MDR-TB strains, but the worrisome fact is that the prevalence of MDR-TB among new cases in some Former Soviet Union countries exceeds 30% [4,5], XDR-TB has been identified in 84 countries and the average proportion of MDR-TB cases with an XDR-TB pattern is 9.0% [3]. Further adding to the problem are the reports of ''totally drug resistant'' TB [6,7], a term currently not recognised by WHO [8,9].Treatment of drug resistant TB is more expensive and more toxic if compared with that prescribed for drugsusceptible TB, and currently takes up to 2 years of therapy [10]. The cost per patient to treat MDR-TB cases is incredibly high [11,12] and, in spite of international public health efforts, the treatment outcome is not very promising [13][14][15]. DIEL et al. [16] showed that direct treatment-related costs of MDR-TB patients can amount to J52 259 in Germany (table 1).In the largest MDR-TB cohort analysed to date [13] the proportion of cases treated successfully was 62%, with 7% failing or relapsing, 9% dying and 17% defaulting; in the XDR-TB subgroup 40% achieved treatment success, 22% failed treatment or relapsed, whereas 15% died and 16% defaulted [14,15].In this issue of the European Respiratory Journal (ERJ) a Dutch group from Groningen [17] reported on the results of a prospective pharmacokinetic (PK) study aimed at quantifying the effect of clarithromycin on the exposure to linezolid. In simple terms they observed that clarithromycin, which has some activity against TB bacilli and is well tolerated, increases linezolid exposure (i.e. increases the blood levels of linezolid, which is a very expensive and toxic drug). The authors decided to quantify this phenomenon administering a fix dose of linezolid (300 mg twice a day) plus a variable one of clarithromycin (250-500 mg once a day).Using validated PK methods they demonstrated that linezolid exposure significantly increased after the coadministration of 500 mg clarithromycin by a median (interquartile range) of 44% (23-102%), when

show abstract

“…There are also reports that suggest that a higher dose of RMP is efficacious without serious adverse effects (25)(26)(27). A number of previous studies showed that low serum levels of INH and/or RMP could be problematic because they are associated with low therapeutic efficacy and relatively high therapeutic failure (28)(29)(30). Although limited data are available on dose and toxicity, physicians may be concerned that attempts to increase the dose of anti-TB drugs may lead to an increase in the frequency of anti-TB DIH.…”

Section: Discussionmentioning

confidence: 99%