Role of therapeutic drug monitoring in the treatment of multi-drug resistant tuberculosis

Nicole F. Maranchick , Charles A. Peloquin
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Abstract

Tuberculosis (TB) is a leading cause of mortality worldwide, and resistance to anti-tuberculosis drugs is a challenge to effective treatment. Multi-drug resistant TB (MDR-TB) can be difficult to treat, requiring long durations of therapy and the use of second line drugs, increasing a patient’s risk for toxicities and treatment failure. Given the challenges treating MDR-TB, clinicians can improve the likelihood of successful outcomes by utilizing therapeutic drug monitoring (TDM). TDM is a clinical technique that utilizes measured drug concentrations from the patient to adjust therapy, increasing likelihood of therapeutic drug concentrations while minimizing the risk of toxic drug concentrations. This review paper provides an overview of the TDM process, pharmacokinetic parameters for MDR-TB drugs, and recommendations for dose adjustments following TDM.

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治疗药物监测在耐多药结核病治疗中的作用
结核病(TB)是导致全球死亡的主要原因,而抗结核药物的耐药性是有效治疗面临的一个挑战。耐多药结核病(MDR-TB)很难治疗,需要长时间的治疗和使用二线药物,增加了患者出现毒性反应和治疗失败的风险。鉴于治疗 MDR-TB 所面临的挑战,临床医生可以通过使用治疗药物监测 (TDM) 来提高成功治疗的可能性。治疗药物监测是一种临床技术,它利用从患者身上测得的药物浓度来调整治疗,从而提高治疗药物浓度的可能性,同时最大限度地降低毒性药物浓度的风险。本综述概述了 TDM 过程、MDR-TB 药物的药代动力学参数以及 TDM 后的剂量调整建议。
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来源期刊
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.00
自引率
5.00%
发文量
44
审稿时长
30 weeks
期刊介绍: Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.
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