Therapeutic drug monitoring in tuberculosis.
Eur J Clin Pharmacol
; 80(11): 1659-1684, 2024 Nov.
Article
en En
| MEDLINE
| ID: mdl-39240337
ABSTRACT
PURPOSE:
Therapeutic drug monitoring (TDM) is a standard clinical procedure that uses the pharmacokinetic and pharmacodynamic parameters of the drug in the body to determine the optimal dose. The pharmacokinetic variability of the drug(s) is a significant contributor to poor treatment outcomes, including the development of acquired drug resistance. TDM aids in dose optimization and improves outcomes while lessening drug toxicity. TDM is used to manage patients with tuberculosis (TB) who exhibit a slow response to therapy, despite good compliance and drug-susceptible organisms. Additional indications include patients at risk of malabsorption or delayed absorption of TB drugs and patients with drug-drug interaction and drug toxicity, which confirm compliance with therapy. TDM usually requires two blood samples the 2 h and the 6 h post-dose. This narrative review will discuss the pharmacokinetics and pharmacodynamics of TB drugs, determinants of poor response to therapy, indications of TDM, methods of performing TDM, and its interpretations.METHODS:
This is a narrative review. We searched PubMed, Embase, and the CINAHL from inception to April 2024. We used the following search terms tuberculosis, therapeutic drug monitoring, anti-TB drugs, pharmacokinetics, pharmacodynamics, limited sample strategies, diabetes and TB, HIV and TB, and multidrug-resistant TB. All types of articles were selected.RESULTS:
TDM is beneficial in managing TB, especially in patients with slow responses, drug-resistance TB, recurrent TB, and comorbidities such as diabetes mellitus and human immunodeficiency virus infection.CONCLUSION:
TDM is beneficial for improving outcomes, reducing the risk of acquired drug resistance, and avoiding side effects.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tuberculosis
/
Monitoreo de Drogas
/
Antituberculosos
Límite:
Humans
Idioma:
En
Revista:
Eur J Clin Pharmacol
Año:
2024
Tipo del documento:
Article
País de afiliación:
India
Pais de publicación:
Alemania