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Plasma concentratio...
Plasma concentrations of second-line antituberculosis drugs in relation to minimum inhibitory concentrations in multidrug-resistant tuberculosis patients in China : a study protocol of a prospective observational cohort study
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- Forsman, Lina Davies (author)
- Karolinska Institutet,Karolinska Inst, Dept Med, Div Infect Dis, Stockholm, Sweden;Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden
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- Niward, Katarina (author)
- Linköpings universitet,Avdelningen för mikrobiologi och molekylär medicin,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland
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- Hu, Yi (author)
- Fudan Univ, Sch Publ Hlth, Dept Epidemiol, Shanghai, Peoples R China;Fudan Univ, Key Lab Publ Hlth Safety, Shanghai, Peoples R China
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- Zheng, Rongrong (author)
- Xiamen City Ctr Dis Control, Dept TB & AIDS Prevent, Xiamen, Peoples R China
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- Zheng, Xubin (author)
- Fudan Univ, Sch Publ Hlth, Dept Epidemiol, Shanghai, Peoples R China;Fudan Univ, Key Lab Publ Hlth Safety, Shanghai, Peoples R China
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- Ke, Ran (author)
- Xiamen City Ctr Dis Control, Dept TB & AIDS Prevent, Xiamen, Peoples R China
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- Cai, Weiping (author)
- Xiamen City Ctr Dis Control, Dept TB & AIDS Prevent, Xiamen, Peoples R China
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- Hong, Chao (author)
- Xiamen City Ctr Dis Control, Dept TB & AIDS Prevent, Xiamen, Peoples R China
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- Li, Yang (author)
- Fudan Univ, Sch Publ Hlth, Dept Epidemiol, Shanghai, Peoples R China;Fudan Univ, Key Lab Publ Hlth Safety, Shanghai, Peoples R China
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- Gao, Yazhou (author)
- Fudan Univ, Sch Publ Hlth, Dept Epidemiol, Shanghai, Peoples R China;Fudan Univ, Key Lab Publ Hlth Safety, Shanghai, Peoples R China
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- Werngren, Jim (author)
- Publ Hlth Agcy Sweden, Dept Microbiol, Stockholm, Sweden
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- Paues, Jakob, 1972- (author)
- Linköpings universitet,Avdelningen för mikrobiologi och molekylär medicin,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland
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- Kuhlin, Johanna (author)
- Karolinska Institutet,Karolinska Inst, Dept Med, Div Infect Dis, Stockholm, Sweden;Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden
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- Simonsson, Ulrika S H, Professor (author)
- Karolinska Institutet,Uppsala universitet,Institutionen för farmaceutisk biovetenskap,Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden,Uppsala Univ, Sweden
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- Eliasson, Erik (author)
- Karolinska Institutet,Karolinska Univ Hosp, Div Clin Pharmacol, Dept Lab Med, Stockholm, Sweden
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- Alffenaar, Jan-Willem (author)
- Univ Groningen, Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, Groningen, Netherlands
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- Mansjo, Mikael (author)
- Publ Hlth Agcy Sweden, Dept Microbiol, Stockholm, Sweden
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- Hoffner, Sven (author)
- Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden
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- Xu, Biao (author)
- Fudan Univ, Sch Publ Hlth, Dept Epidemiol, Shanghai, Peoples R China;Fudan Univ, Key Lab Publ Hlth Safety, Shanghai, Peoples R China
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- Schön, Thomas (author)
- Linköpings universitet,Avdelningen för mikrobiologi och molekylär medicin,Medicinska fakulteten,Kalmar Cty Hosp, Sweden
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- Bruchfeld, Judith (author)
- Karolinska Institutet,Karolinska Inst, Dept Med, Div Infect Dis, Stockholm, Sweden;Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden
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(creator_code:org_t)
- 2018-10-04
- 2018
- English.
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In: BMJ Open. - : BMJ. - 2044-6055. ; 8:9
- Related links:
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https://doi.org/10.1...
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https://bmjopen.bmj....
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
Close
- Individualised treatment through therapeutic drug monitoring (TDM) may improve tuberculosis (TB) treatment outcomes but is not routinely implemented. Prospective clinical studies of drug exposure and minimum inhibitory concentrations (MICs) in multidrug-resistant TB (MDR-TB) are scarce. This translational study aims to characterise the area under the concentration-time curve of individual MDR-TB drugs, divided by the MIC for Mycobacterium tuberculosis isolates, to explore associations with markers of treatment progress and to develop useful strategies for clinical implementation of TDM in MDR-TB.Methods and analysis: Adult patients with pulmonary MDR-TB treated in Xiamen, China, are included. Plasma samples for measure of drug exposure are obtained at 0, 1, 2, 4, 6, 8 and 10 hours after drug intake at week 2 and at 0, 4 and 6 hours during weeks 4 and 8. Sputum samples for evaluating time to culture positivity and MIC determination are collected at days 0, 2 and 7 and at weeks 2, 4, 8 and 12 after treatment initiation. Disease severity are assessed with a clinical scoring tool (TBscore II) and quality of life evaluated using EQ-5D-5L. Drug concentrations of pyrazinamide, ethambutol, levofloxacin, moxifloxacin, cycloserine, prothionamide and para-aminosalicylate are measured by liquid chromatography tandem-mass spectrometry and the levels of amikacin measured by immunoassay. Dried blood spot on filter paper, to facilitate blood sampling for analysis of drug concentrations, is also evaluated. The MICs of the drugs listed above are determined using custom-made broth microdilution plates and MYCOTB plates with Middlebrook 7H9 media. MIC determination of pyrazinamide is performed in BACTEC MGIT 960.Ethics and dissemination: This study has been approved by the ethical review boards of Karolinska Institutet, Sweden and Fudan University, China. Informed written consent is given by participants. The study results will be submitted to a peer-reviewed journal. Trial registration number NCT02816931; Pre-results.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmaceutiska vetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmaceutical Sciences (hsv//eng)
Keyword
- tuberculosis
- clinical pharmacology
- public health
- microbiology
Publication and Content Type
- ref (subject category)
- art (subject category)
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BMJ Open
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Forsman, Lina Da ...
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Niward, Katarina
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Hu, Yi
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Zheng, Rongrong
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Zheng, Xubin
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Ke, Ran
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show more...
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Cai, Weiping
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Hong, Chao
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Li, Yang
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Gao, Yazhou
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Werngren, Jim
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Paues, Jakob, 19 ...
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Kuhlin, Johanna
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Simonsson, Ulrik ...
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Eliasson, Erik
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Alffenaar, Jan-W ...
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Mansjo, Mikael
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Hoffner, Sven
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Xu, Biao
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Schön, Thomas
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Bruchfeld, Judit ...
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MEDICAL AND HEAL ...
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MEDICAL AND HEAL ...
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BMJ Open
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Uppsala University
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Karolinska Institutet
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Linköping University