Exposure of anti-infective drugs and the dynamic changes of the gut microbiota during gastrointestinal mucositis in autologous stem cell transplant patients: a pilot study.

Autor: Märtson AG; Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. a.martson@umcg.nl., da Silva Ferreira AR; Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Veringa A; Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Liu L; Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Wardill HR; Adelaide Medical School, The University of Adelaide, Adelaide, Australia.; Precision Medicine (Cancer), South Australian Health and Medical Research Institute, Adelaide, Australia., Junier LAT; Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., van der Werf TS; Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.; Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Harmsen HJM; Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Sturkenboom MGG; Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Span LF; Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Tissing WJE; Department of Pediatrics (Oncology and Hematology), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.; Princess Maxima Centre for Pediatric Oncology, Utrecht, The Netherlands., Alffenaar JC; Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.; Westmead Hospital, Sydney, NSW, Australia.; Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia.
Jazyk: angličtina
Zdroj: Annals of hematology [Ann Hematol] 2023 Feb; Vol. 102 (2), pp. 421-427. Date of Electronic Publication: 2023 Jan 17.
DOI: 10.1007/s00277-023-05091-y
Abstrakt: Gastrointestinal mucositis could potentially compromise drug absorption due to functional loss of mucosa and other pathophysiological changes in the gastrointestinal microenvironment. Little is known about this effect on commonly used anti-infectives. This study aimed to explore the association between different stages of gastrointestinal mucositis, drug exposure, and gut microbiota. A prospective, observational pilot study was performed in HSCT patients aged ≥ 18 years receiving anti-infectives orally. Left-over blood samples and fecal swabs were collected from routine clinical care until 14 days after HSCT to analyze drug and citrulline concentrations and to determine the composition of the gut microbiota. 21 patients with a median age of 58 (interquartile range 54-64) years were included with 252 citrulline, 155 ciprofloxacin, 139 fluconazole, and 76 acyclovir concentrations and 48 fecal swabs obtained. Severe gastrointestinal mucositis was observed in all patients. Due to limited data correlation analysis was not done for valacyclovir and fluconazole, however we did observe a weak correlation between ciprofloxacin and citrulline concentrations. This could suggest that underexposure of ciprofloxacin can occur during severe mucositis. A follow-up study using frequent sampling rather than the use of left-over would be required to investigate the relationship between gastrointestinal mucositis, drug exposure, and gut microbiome.
(© 2023. The Author(s).)
Databáze: MEDLINE
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