Bacterial factors that predict relapse after tuberculosis therapy. Southeast National Tuberculosis Center, Gainesville, FLġ. King Saud University, Riyadh, Saudi Arabia More precise knowledge of important variables involved in the treatment of patients with tuberculosis should allow for improved outcomes in these patients. We suspect that the expense of therapeutic drug monitoring would be more than offset by the reduced costs associated with more effective and shorter durations of treatment. We hope that further guidance regarding MICs and therapeutic drug monitoring will be forthcoming from the World Health Organization.
5 In certain circumstances, a 4-month regimen may be feasible with higher drug exposures. found that therapeutic drug monitoring reduced the time to culture conversion in patients with diabetes and tuberculosis. 3,4 Isolates with higher MICs and patients with low plasma concentrations suggest a need for higher drug doses.Īs an alternative to guessing, therapeutic drug monitoring may help to guide medication dosing. The ratio of the fAUC to the MIC in antituberculosis drugs is highly variable. Access to sites of infection is difficult, and plasma concentrations serve as practical surrogates. Most antituberculosis drugs have concentration-dependent activity (expressed as the ratio of the serum free-drug area under the concentration versus time curve to the MIC). Standardized dosing is also not appropriate for all patients. We agree that critical concentrations may not be appropriate for all patients. 30 issue) 1 report that higher minimum inhibitory concentration (MIC) values of rifampin and isoniazid were associated with a greater risk of treatment failure and relapse of tuberculosis than lower MIC values. The most trusted, influential source of new medical knowledge and clinical best practices in the world.Ĭolangeli et al.
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