Drug resistant TB is increasing and in order to enchance the efficacy of the current drugs, individualized therapy using plasma drug concentrations and minimal inhibitory concentration (MIC) determination may be of importance. This concept is defined as therapeutic drug monitoring (TDM). In this pilot study our hypothesis is that the ratio between MIC and drug concentration data is correlated to the bacterial load measured as time to positive liquid culture (TTP). In two sites in Sweden (Linköping and Karolinska Hospital Solna, Stockholm), 25 patients with pulmonary tuberculosis will be recruited. MIC-determination of Mycobacterium tuberculosis will be performed in BACTEC 960 MGIT and drug concentration will be determined at 2, 4 and 12 weeks after treatment initiation using LC-MS/MS methodology. Sputum cultures will be obtained at 0, 2 days, 7 days, 2 weeks, 4 weeks and 8 weeks and TTP will be measured in duplicate samples. Clinical follow up according to WHO criteria will be performed 1 year after completion of treatment.
Study Type
OBSERVATIONAL
Enrollment
38
Dept of Infectious Diseases
Linköping, Linköping, Sweden
Dept of Infectious Diseases, TB-unit, Karolinska Hospital
Stockholm, Stockholm County, Sweden
Rifampicin concentration in relationship to MIC over 10
Time frame: 2 weeks
Cure rate on Clinical follow up (according to WHO criteria) in relation to rifampicin concentration at week 2
Time frame: 1 year
Sputum Culture conversion in relation to rifampicin, isoniazid and pyrazinamid concentration week 2
Time frame: 2 and 8 weeks
TB-score in relation to rifampicin, isoniazid and pyrazinamid concentration week 2
Time frame: 8 weeks
Time to positive Culture (TTP) in relation to isoniazid, ethambutol and pyrazinamid serum concentration and minimal inhibitory concentration (MIC)
Time frame: 2 and 8 weeks
Time to positive Culture (TTP) in relation to rifampicin serum concentration and minimal inhibitory concentration (MIC)
Time frame: 2weeks
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.