Simple strategy to assess linezolid exposure in patients with multi-drug-resistant and extensively-drug-resistant tuberculosis

Kamp, Jasper; Bolhuis, Mathieu S.; Tiberi, Simon; Akkerman, Onno W.; Centis, Rosella; Lange, Wiel C M de; Kosterink, Jos G. W.; Werf, Tjip S. van der; Migliori, Giovanni Battista; Alffenaar, Jan Willem

doi:10.1016/j.ijantimicag.2017.01.017

Cited by 36 publications

(33 citation statements)

References 27 publications

(36 reference statements)

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“…For these reasons, we expect the results reported here to represent the clinical practice of TDM using these LSSs very closely. The small sample size of the MFXϩRIF group can be considered a limitation as well, although comparable to previously published LSS studies (21,(37)(38)(39)(40). We consider this sample size to be sufficient for exploratory objectives, since this is the first study that…”

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confidence: 66%

Limited Sampling Strategies Using Linear Regression and the Bayesian Approach for Therapeutic Drug Monitoring of Moxifloxacin in Tuberculosis Patients

Elsen

Sturkenboom

Akkerman

et al. 2019

Antimicrob Agents Chemother

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Therapeutic drug monitoring (TDM) of moxifloxacin is recommended to improve the response to tuberculosis treatment and reduce acquired drug resistance. Limited sampling strategies (LSSs) are able to reduce the burden of TDM by using a small number of appropriately timed samples to estimate the parameter of interest, the area under the concentration-time curve. This study aimed to develop LSSs for moxifloxacin alone (MFX) and together with rifampin (MFX+RIF) in tuberculosis (TB) patients. Population pharmacokinetic (popPK) models were developed for MFX (n = 77) and MFX+RIF (n = 24). In addition, LSSs using Bayesian approach and multiple linear regression were developed. Jackknife analysis was used for internal validation of the popPK models and multiple linear regression LSSs. Clinically feasible LSSs (one to three samples, 6-h timespan postdose, and 1-h interval) were tested. Moxifloxacin exposure was slightly underestimated in the one-compartment models of MFX (mean –5.1%, standard error [SE] 0.8%) and MFX+RIF (mean –10%, SE 2.5%). The Bayesian LSSs for MFX and MFX+RIF (both 0 and 6 h) slightly underestimated drug exposure (MFX mean –4.8%, SE 1.3%; MFX+RIF mean –5.5%, SE 3.1%). The multiple linear regression LSS for MFX (0 and 4 h) and MFX+RIF (1 and 6 h), showed mean overestimations of 0.2% (SE 1.3%) and 0.9% (SE 2.1%), respectively. LSSs were successfully developed using the Bayesian approach (MFX and MFX+RIF; 0 and 6 h) and multiple linear regression (MFX, 0 and 4 h; MFX+RIF, 1 and 6 h). These LSSs can be implemented in clinical practice to facilitate TDM of moxifloxacin in TB patients.

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confidence: 66%

Limited Sampling Strategies Using Linear Regression and the Bayesian Approach for Therapeutic Drug Monitoring of Moxifloxacin in Tuberculosis Patients

Elsen

Sturkenboom

Akkerman

et al. 2019

Antimicrob Agents Chemother

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“…Therefore, maintaining linezolid C min between 2 and 7 mg/L is recommended for optimal drug exposure whilst minimising haematological toxicity [88]. Alternatively, TDM via LSS can be used [89].…”

Section: Tdm In Critically Ill Patientsmentioning

confidence: 99%

Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper#

et al. 2020

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Purpose: This Position Paper aims to review and discuss the available data on therapeutic drug monitoring (TDM) of antibacterials, antifungals and antivirals in critically ill adult patients in the intensive care unit (ICU). This Position Paper also provides a practical guide on how TDM can be applied in routine clinical practice to improve therapeutic outcomes in critically ill adult patients. Methods: Literature review and analysis were performed by Panel Members nominated by the endorsing organisations,

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“…In three cases, there was no AUC 0-24h available for the lowest dose due to logistical issues. In these cases, the total AUC 0-24h of the lowest dose was calculated using our linezolid pharmacokinetic model [11] in MWPharm++ (Mediware, Groningen, the Netherlands). The median (range) total AUC/MIC ratio was 196 (98-276), with all except one patient attaining the target of 100 that is used in our clinic, based on a systematic review of literature [12].…”

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confidence: 99%

“…However, since the absorption of linezolid is usually fast and complete, PK of linezolid is non-linear, and we performed TDM, we do not expect this to impact the treatment outcome. Furthermore, TDM is not available everywhere, but dried blood spots (DBS) [15] combined with limited sampling methods [11] might allow for this strategy to be implemented in other settings. There is still an ongoing discussion on the most appropriate PK/PD target for linezolid.…”

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confidence: 99%

Treatment of multidrug-resistant tuberculosis using therapeutic drug monitoring: first experiences with sub-300 mg linezolid dosages using in-house made capsules

et al. 2019

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Simple strategy to assess linezolid exposure in patients with multi-drug-resistant and extensively-drug-resistant tuberculosis

Cited by 36 publications

References 27 publications

Limited Sampling Strategies Using Linear Regression and the Bayesian Approach for Therapeutic Drug Monitoring of Moxifloxacin in Tuberculosis Patients

Limited Sampling Strategies Using Linear Regression and the Bayesian Approach for Therapeutic Drug Monitoring of Moxifloxacin in Tuberculosis Patients

Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper#

Treatment of multidrug-resistant tuberculosis using therapeutic drug monitoring: first experiences with sub-300 mg linezolid dosages using in-house made capsules

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