Tuberculosis and pharmacological interactions: A narrative review

Riccardi, Niccolò; Canetti, Diana; Rodari, Paola; Besozzi, Giorgio; Saderi, Laura; Dettori, Marco; Codecasa, Luigi; Sotgiu, Giovanni

doi:10.1016/j.crphar.2020.100007

Cited by 16 publications

(13 citation statements)

References 91 publications

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“…In addition, some of the patients with BCGosis are later turn out to be SCID and other IEIs susceptible to fungal infections. To build an effective anti-TB regimen in such patients, probable drug interactions with azole antifungals should be addressed and second-line anti-TB medications can be used interchangeably [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Effective anti-mycobacterial treatment for BCG disease in patients with Mendelian Susceptibility to Mycobacterial Disease (MSMD): a case series

Mahdaviani

Fallahi

Jamee

et al. 2022

Ann Clin Microbiol Antimicrob

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Background Post-vaccination BCG disease typically attests to underlying inborn errors of immunity (IEIs), with the highest rates of complications in patients with Mendelian susceptibility to mycobacterial disease (MSMD). However, therapeutic protocols for the management of BCG-osis (disseminated) and persistent BCG-itis (localized) are still controversial. Methods Twenty-four Iranian patients with MSMD (BCG-osis or BCG-itis), followed from 2009 to 2020 in Tehran, were included in the study. Their medical records were retrospectively reviewed for demographics, clinical features, laboratory findings, and molecular diagnosis. The therapeutic protocol sheets were prepared to contain the types and duration of anti-mycobacterial agents. Results BCG disease either as BCG-itis (33.3%) or BCG-osis (66.7%) was confirmed in all patients by positive gastric washing test (54.2%), microbial smear and culture (58.3%), or purified protein derivative (PPD) test (4.2%). The duration between BCG-osis onset and MSMD diagnosis was 21.6 months. All except three patients were initiated on second-line anti-mycobacterial agents with either a fluoroquinolone (levofloxacin: 15 mg/kg/day, ciprofloxacin: 20 mg/kg/day, ofloxacin: 15 mg/kg/day), aminoglycoside (amikacin: 10–15 mg/kg/day, streptomycin: 15 mg/kg/day), and/or macrolide (clarithromycin: 15 mg/kg/day) along with oral rifampin (10 mg/kg/day), isoniazid (15 mg/kg/day), and ethambutol (20 mg/kg/day). Three patients showed a clinical response to rifampin, despite in vitro resistance. Fourteen (58.3%) patients received also adjuvant subcutaneous IFN-γ therapy, 50 µ/m2 every other day. At the end of survey, most patients (n = 22, 91.7%) were alive and two patients died following BCG-osis and respiratory failure. Conclusions We recommend the early instigation of second-line anti-mycobacterial agents in MSMD patients with BCG disease.

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Section: Discussionmentioning

confidence: 99%

Effective anti-mycobacterial treatment for BCG disease in patients with Mendelian Susceptibility to Mycobacterial Disease (MSMD): a case series

Mahdaviani

Fallahi

Jamee

et al. 2022

Ann Clin Microbiol Antimicrob

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“…Rifamycins (RIF, rifapentine [RPT], rifabutin) induce several cytochrome P450 (CYP450) enzymes and drug transporters, which can significantly decrease concentrations of drugs eliminated via these routes. 40 , 41 Conversely, INH inhibits a range of CYP450 enzymes, including CYP3A4 and therefore can increase concentrations of drugs metabolised by this enzyme. 42 As the inductive effect of RIF generally outweighs the inhibitory effect of INH, the overall effect is a net decrease in the concentrations of many drugs.…”

Section: Standardmentioning

confidence: 99%

Clinical standards for the dosing and management of TB drugs

Alffenaar

Stocker

Forsman

et al. 2022

int j tuberc lung dis

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BACKGROUND: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on ‘best practice´ for dosing and management of TB drugs.METHODS: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants.RESULTS: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified.CONCLUSION: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.

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“…TZD is used as a second-line treatment option in multi-drug resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) for non-psychotic adult or pediatric patients. However, it is principally known to cause polyneuropathic side effects [3,4]. Pyridoxine hydrochloride (PDX), also known as Vitamin B 6 , is a water-soluble compound involved in several enzymatic reactions in the human body.…”

Section: Introductionmentioning

confidence: 99%

A Validated RP-HPLC Method for the Simultaneous Detection and Quantification of Pyridoxine and Terizidone in Pharmaceutical Formulations

2021

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Tuberculosis (TB) remains a life-threatening infection, and it is well-known that effective TB treatment is associated with multiple drugs administered to infected patients on a daily basis. Terizidone (TZD) is an anti-TB drug used in the treatment of multi-drug resistant and extensively drug-resistant TB but presents with polyneuropathic adverse effects in some patients. To counteract these adverse effects, TZD is typically prescribed with pyridoxine (PDX), well known as Vitamin B6. As part of a pre-formulation study investigating the potential to co-formulate these two compounds, it became necessary to have a simple and reliable reversed-phase high-performance liquid chromatography (RP-HPLC) method. Optimal, simultaneous separation and detection of TZD and PDX were obtained using an isocratic mobile phase setup, consisting of ultrapure water and acetonitrile (30:70% v/v), with 1 mL glacial acetic acid added to the mobile phase mixture. A Discovery® C18, 150 × 4.6 mm, 5 μm column maintained at ambient temperature was utilized, with a detection wavelength of 260 nm. The method was validated in terms of linearity, accuracy, precision, limit of detection (LOD), limit of quantification (LOQ), specificity, robustness, and solution stability. Validation proved this method to be acceptable and reliable for the simultaneous accurate detection and quantification of TZD and PDX.

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Tuberculosis and pharmacological interactions: A narrative review

Cited by 16 publications

References 91 publications

Effective anti-mycobacterial treatment for BCG disease in patients with Mendelian Susceptibility to Mycobacterial Disease (MSMD): a case series

Effective anti-mycobacterial treatment for BCG disease in patients with Mendelian Susceptibility to Mycobacterial Disease (MSMD): a case series

Clinical standards for the dosing and management of TB drugs

A Validated RP-HPLC Method for the Simultaneous Detection and Quantification of Pyridoxine and Terizidone in Pharmaceutical Formulations

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