Clinical relevance of rifampicin-moxifloxacin interaction in isoniazid resistant/intolerant tuberculosis patients
| Autor: | Tjip S. van der Werf, Dick van Soolingen, Marieke G G Sturkenboom, Onno W. Akkerman, Richard M. Anthony, Wiel C M de Lange, Mathieu S. Bolhuis, Vanessa B Vogensen, Huib A. M. Kerstjens, Jan-Willem C. Alffenaar |
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| Přispěvatelé: | Microbes in Health and Disease (MHD), Groningen Research Institute for Asthma and COPD (GRIAC) |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Drug
medicine.medical_specialty Tuberculosis media_common.quotation_subject Moxifloxacin Antitubercular Agents Clinical Therapeutics Gastroenterology Minimum inhibitory concentration Internal medicine Tuberculosis Multidrug-Resistant medicine Isoniazid Humans Pharmacology (medical) Clinical significance heterocyclic compounds media_common Retrospective Studies Pharmacology business.industry Retrospective cohort study biochemical phenomena metabolism and nutrition medicine.disease bacterial infections and mycoses Infectious Diseases Rifampin business Rifampicin medicine.drug |
| Zdroj: | Antimicrobial Agents and Chemotherapy, 66(2):e01829-21. AMER SOC MICROBIOLOGY Antimicrob Agents Chemother |
| ISSN: | 1098-6596 |
| Popis: | Moxifloxacin is an attractive drug for the treatment of isoniazid-resistant rifampicin-susceptible tuberculosis (TB) or drug-susceptible TB complicated by isoniazid intolerance. However, co-administration with rifampicin decreases moxifloxacin exposure. It remains unclear whether this drug-drug interaction has clinical implications. This retrospective study in a Dutch TB centre investigated how rifampicin affected moxifloxacin exposure in patients with isoniazid-resistant or -intolerant TB. Moxifloxacin exposures were measured between 2015 and 2020 in 31 patients with isoniazid-resistant or -intolerant TB receiving rifampicin, and 20 TB patients receiving moxifloxacin without rifampicin. Moxifloxacin exposure, i.e. area under the concentration-time curve (AUC0-24h), and attainment of AUC0-24h/minimal inhibitory concentration (MIC) > 100 were investigated for 400 mg moxifloxacin and 600 mg rifampicin, and increased doses of moxifloxacin (600 mg) or rifampicin (900 mg). Moxifloxacin AUC0-24h and peak concentration with a 400 mg dose were decreased when rifampicin was co-administered compared to moxifloxacin alone (ratio of geometric means 0.61 (90% CI (0.53, 0.70) and 0.81 (90% CI (0.70, 0.94), respectively). Among patients receiving rifampicin, 65% attained an AUC0-24h/MIC > 100 for moxifloxacin compared to 78% of patients receiving moxifloxacin alone; this difference was not significant. Seven out of eight patients receiving an increased dose of 600 mg moxifloxacin reached the target AUC0-24h/MIC > 100. This study showed a clinically significant 39% decrease in moxifloxacin exposure when rifampicin was co-administered. Moxifloxacin dose adjustment may compensate for this drug-drug interaction. Further exploring the impact of higher doses of these drugs in patients with isoniazid resistance or intolerance is paramount. |
| Databáze: | OpenAIRE |
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