Yonsei Med J.
2015 Jul;56(4):961-967. 10.3349/ymj.2015.56.4.961.
Low Serum Concentrations of Moxifloxacin, Prothionamide, and Cycloserine on Sputum Conversion in Multi-Drug Resistant TB
- Affiliations
-
- 1Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
- 2Department of Pharmacology and Pharmacogenomics Research Center, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. dhkim@inje.ac.kr
- 3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
- KMID: 2366335
- DOI: http://doi.org/10.3349/ymj.2015.56.4.961
Abstract
- PURPOSE
Low serum concentrations of drugs used to treat multi-drug resistant tuberculosis (MDR-TB) have occasionally been associated with treatment failure. We determined the frequencies of low serum concentrations of anti-MDR-TB drugs, and assessed the effects of these concentrations on 2-month sputum conversion.
MATERIALS AND METHODS
The serum levels of moxifloxacin (MF), prothionamide (PTH), and cycloserine (CS) were determined for 89 serum samples by high-pressure liquid chromatography-tandem mass spectrometry.
RESULTS
Low serum concentrations of MF, PTH, and CS below the minimal levels of the normal ranges were 83.3% (20/24), 59.2% (29/49), and 71.2% (47/66), respectively. There were no significant differences between the 2-month sputum conversion group (n=25) and the 2-month sputum non-conversion group (n=4) in median drug concentrations (microg/mL) of MF (1.46 vs. 1.60), PTH (0.91 vs. 0.70), and CS (14.90 vs. 14.90). However, a poor compliance rate was significantly greater in the 2-month sputum non-conversion group (75.0%, 3/4) than in the 2-month sputum conversion group (0%, 0/25) (p=0.001).
CONCLUSION
The frequency of low serum concentrations of anti-MDR-TB drugs was substantial and might not affect the 2-month sputum conversion rate. Larger prospective studies with timely sampling are needed to investigate the role of therapeutic drug monitoring in MDR-TB.
Keyword
MeSH Terms
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Adult
Aged
Antitubercular Agents/blood/*pharmacokinetics/therapeutic use
Chromatography, High Pressure Liquid
Cycloserine/blood/*pharmacokinetics/therapeutic use
Fluoroquinolones/blood/*pharmacokinetics/therapeutic use
Humans
Medication Adherence
Middle Aged
Prothionamide/blood/*pharmacokinetics/therapeutic use
Retrospective Studies
Sputum/*microbiology
Tandem Mass Spectrometry
Tuberculosis, Multidrug-Resistant/blood/*drug therapy
Young Adult
Antitubercular Agents
Cycloserine
Fluoroquinolones
Prothionamide
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