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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Serum concentrations of antimycobacterial drugs in patients with pulmonary tuberculosis in Botswana
Clinical Infectious Diseases, Volume 41, No. 4, Year 2005
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Description
Background. We conducted a pharmacokinetic study of antimycobacterial drugs involving a cohort of patients with pulmonary tuberculosis (TB) in Gaborone, Botswana, to assess the prevalence of and risk factors for low drug concentrations in serum. Methods. Adults participated if they had a history of cough ≥2 weeks, had abnormal chest radiograph findings, consented to testing for human immunodeficiency virus (HIV), had sputum cultures positive for Mycobacterium tuberculosis, and were receiving antituberculous therapy for >7 days. Observed maximum serum concentrations were compared with published normal ranges. Results. Of 91 patients enrolled, 89 (98%) were outpatients, and 59 (68%) of 87 patients tested had HIV infection. The following numbers of patients had low serum concentrations of the following drugs: isoniazid, 27 (30%) of 90; rifampin, 71 (78%) of 91; ethambutol, 37 (41%) of 91; and pyrazinamide, 1 (1%) of 91. Low serum concentrations of both isoniazid and rifampin occurred in 23 (26%) of 90 patients. Low serum concentrations of rifampin were found in both HIV-infected and non-HIV-infected patients, and such patients were less likely to have >4 weeks of symptoms, more likely to have lymphadenopathy, and more likely to have low serum albumin levels (P < .05 for all). The associations with noncavitary pulmonary disease (P = .12) and HIV infection (P = .07) did not reach statistical significance. Delayed absorption was most common with ethambutol, followed by rifampin. Conclusions. These data, predominantly from HIV-infected patients with TB, suggest that low isoniazid, rifampin, and ethambutol concentrations are common in Botswana. In contrast, pyrazinamide usually is well absorbed. © 2005 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Tappero, Jordan W.
United States, Atlanta
Centers for Disease Control and Prevention
Agerton, Tracy B.
United States, Atlanta
Centers for Disease Control and Prevention
United States, Berkeley
University of California, Berkeley
Hopewell, Philip C.
United States, San Francisco
University of California, San Francisco
United States, San Francisco
San Francisco General Hospital and Trauma Center
Reingold, Arthur Lawrence
United States, Berkeley
University of California, Berkeley
Lockman, Shahin
United States, Atlanta
Centers for Disease Control and Prevention
Oyewo, Aderonke
Unknown Affiliation
Talbot, Elizabeth A.S.
United States, Atlanta
Centers for Disease Control and Prevention
Kenyon, Thomas A.
United States, Atlanta
Centers for Disease Control and Prevention
Moeti, Themba Lebogang
Unknown Affiliation
Moffat, Howard J.
Unknown Affiliation
Peloquin, Charles Arthur
United States, Denver
National Jewish Medical and Research Center
United States, Denver
University of Colorado Denver
Statistics
Citations: 131
Authors: 11
Affiliations: 6
Identifiers
Doi:
10.1086/431984
ISSN:
10584838
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Botswana