TOC summary: Diabetes was associated with increased risk for slow response and low rifampin levels

Alisjahbana

American Thoracic Society and the Centers for Disease Control and Prevention

American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Disease Society of America

Blumberg

Chang

Chideya

Davies

Diacon

Dooley

Eric R. Houpt

Gelband

Gwilt

Holdiness

Holland

Jane L. Moore

Jeon

Kenny

Kimerling

Malone

McIlleron

Mehta

Narita

Nijland

Panchagnula

Patel

Peloquin

Scott K. Heysell

Sirgel

Stevenson

Suzanne J. Keller

Emerging Infectious Diseases

English

PubMed

Therapeutic drug monitoring may be useful in tuberculosis management, but programmatic implementation is understudied. We performed a retrospective cohort study to determine prevalence of lower than expected levels of isoniazid, rifampin, ethambutol, and pyrazinamide measured at time of estimated peak serum concentration. Patients were tested for serum concentration at 2 hours after medication administration. When patients were tested, 22 had concentrations lower than expected range for rifampin, 23 of 39 patients had low levels of isoniazid, and 8 of 26 patients had low levels of ethambutol; all 20 patients tested for pyrazinamide were within expected range. Over 26 months, 42 patients met criteria for slow response. Diabetes was associated with slow response (p<0.001), and persons with diabetes were more likely than persons without diabetes to have low rifampin levels (p = 0.03). Dosage adjustment of rifampin was more likely to elevate serum concentration to the target range than adjustment of isoniazid given in daily doses (p = 0.01)

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Therapeutic Drug Monitoring for Slow Response to Tuberculosis Treatment in a State Control Program, Virginia, USA

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Therapeutic Drug Monitoring for Slow Response to Tuberculosis Treatment in a State Control Program, Virginia, USA

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