W-Y Hung1, M-C Yu1, Y-C Chiang2, J-H Chang1, C-Y Chiang1, C-C Chang3, H-C Chuang4, K-J Bai1. 1. Division of Pulmonary Medicine, Departments of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 2. School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan. 3. Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 4. Division of Pulmonary Medicine, Departments of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
Abstract
BACKGROUND: Therapeutic drug monitoring (TDM) has been advocated to promote the efficacy of anti-tuberculosis agents. Cycloserine (CS) is a second-line anti-tuberculosis drug whose serum concentrations in tuberculosis (TB) patients are largely unknown. OBJECTIVES: To investigate serum CS concentrations after drug ingestion in TB patients. METHODS: Multidrug-resistant TB patients who were taking CS in a tertiary care centre in northern Taiwan between 1 April 2009 and 31 October 2009 were enrolled in the study. Serum CS concentrations were measured at 2 and 6 h after drug administration. RESULTS: Of 32 patients enrolled, 23 were males and 9 females. The mean CS dose was 8.8 ± 1.3 mg/kg. The mean serum concentrations at 2 and 6 h were respectively 19.7 ± 8.3 and 18.1 ± 8.7 μg/ml. Seven patients (22%) had serum drug concentrations that were higher at 6 h than at 2 h, 12 (38%) had peak serum concentrations within the recommended range of 20-35 μg/ml; 18 patients (56%) had concentrations <20 μg/ml at both 2 h and 6 h; and 2 patients (6%) had at least one measurement >35 μg/ml. CONCLUSION: Lower than recommended serum CS concentrations and delayed absorption were common. It is essential to develop practical TDM to maintain proper serum drug concentrations.
BACKGROUND: Therapeutic drug monitoring (TDM) has been advocated to promote the efficacy of anti-tuberculosis agents. Cycloserine (CS) is a second-line anti-tuberculosis drug whose serum concentrations in tuberculosis (TB) patients are largely unknown. OBJECTIVES: To investigate serum CS concentrations after drug ingestion in TB patients. METHODS: Multidrug-resistant TB patients who were taking CS in a tertiary care centre in northern Taiwan between 1 April 2009 and 31 October 2009 were enrolled in the study. Serum CS concentrations were measured at 2 and 6 h after drug administration. RESULTS: Of 32 patients enrolled, 23 were males and 9 females. The mean CS dose was 8.8 ± 1.3 mg/kg. The mean serum concentrations at 2 and 6 h were respectively 19.7 ± 8.3 and 18.1 ± 8.7 μg/ml. Seven patients (22%) had serum drug concentrations that were higher at 6 h than at 2 h, 12 (38%) had peak serum concentrations within the recommended range of 20-35 μg/ml; 18 patients (56%) had concentrations <20 μg/ml at both 2 h and 6 h; and 2 patients (6%) had at least one measurement >35 μg/ml. CONCLUSION: Lower than recommended serum CS concentrations and delayed absorption were common. It is essential to develop practical TDM to maintain proper serum drug concentrations.
Authors: Devyani Deshpande; Jan-Willem C Alffenaar; Claudio U Köser; Keertan Dheda; Moti L Chapagain; Noviana Simbar; Thomas Schön; Marieke G G Sturkenboom; Helen McIlleron; Pooi S Lee; Thearith Koeuth; Stellah G Mpagama; Sayera Banu; Suporn Foongladda; Oleg Ogarkov; Suporn Pholwat; Eric R Houpt; Scott K Heysell; Tawanda Gumbo Journal: Clin Infect Dis Date: 2018-11-28 Impact factor: 9.079
Authors: Payam Nahid; Sundari R Mase; Giovanni Battista Migliori; Giovanni Sotgiu; Graham H Bothamley; Jan L Brozek; Adithya Cattamanchi; J Peter Cegielski; Lisa Chen; Charles L Daley; Tracy L Dalton; Raquel Duarte; Federica Fregonese; C Robert Horsburgh; Faiz Ahmad Khan; Fayez Kheir; Zhiyi Lan; Alfred Lardizabal; Michael Lauzardo; Joan M Mangan; Suzanne M Marks; Lindsay McKenna; Dick Menzies; Carole D Mitnick; Diana M Nilsen; Farah Parvez; Charles A Peloquin; Ann Raftery; H Simon Schaaf; Neha S Shah; Jeffrey R Starke; John W Wilson; Jonathan M Wortham; Terence Chorba; Barbara Seaworth Journal: Am J Respir Crit Care Med Date: 2019-11-15 Impact factor: 21.405
Authors: Wael A Alghamdi; Abdullah Alsultan; Mohammad H Al-Shaer; Guohua An; Shahriar Ahmed; Yosra Alkabab; Sayera Banu; Ketevan Barbakadze; Eric Houpt; Maia Kipiani; Lali Mikiashvili; Stephan Schmidt; Scott K Heysell; Russell R Kempker; J Peter Cegielski; Charles A Peloquin Journal: Antimicrob Agents Chemother Date: 2019-04-25 Impact factor: 5.191
Authors: Marieke G G Sturkenboom; Anne-Grete Märtson; Elin M Svensson; Derek J Sloan; Kelly E Dooley; Simone H J van den Elsen; Paolo Denti; Charles A Peloquin; Rob E Aarnoutse; Jan-Willem C Alffenaar Journal: Clin Pharmacokinet Date: 2021-03-06 Impact factor: 6.447