Low Serum Concentrations of Moxifloxacin, Prothionamide, and Cycloserine on Sputum Conversion in Multi-Drug Resistant TB.
10.3349/ymj.2015.56.4.961
- Author:
Seung Heon LEE
1
;
Kyung Ah SEO
;
Young Min LEE
;
Hyun Kyung LEE
;
Je Hyeong KIM
;
Chol SHIN
;
Jong Ryul GHIM
;
Jae Gook SHIN
;
Dong Hyun KIM
Author Information
1. Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
- Publication Type:Original Article ; Observational Study ; Research Support, Non-U.S. Gov't
- Keywords:
Tuberculosis;
multidrug resistance;
moxifloxacin;
prothionamide;
cycloserine;
drug monitoring
- MeSH:
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
- From:Yonsei Medical Journal
2015;56(4):961-967
- CountryRepublic of Korea
- Language:English
-
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.
