RT Journal Article
SR Electronic
T1 Evaluation of moxifloxacin for the treatment of tuberculosis: 3 years of experience
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 888
OP 894
DO 10.1183/09031936.00176610
VO 38
IS 4
A1 A.D. Pranger
A1 R. van Altena
A1 R.E. Aarnoutse
A1 D. van Soolingen
A1 D.R.A. Uges
A1 J.G.W. Kosterink
A1 T.S. van der Werf
A1 J.W.C. Alffenaar
YR 2011
UL http://erj.ersjournals.com/content/38/4/888.abstract
AB Moxifloxacin (MFX) is a powerful second-line anti-tuberculosis (TB) agent, but the optimal dose has not yet been established and long-term safety data are scarce. We retrospectively reviewed the medical charts of TB patients treated at the Tuberculosis Centre Beatrixoord, University Medical Centre Groningen (Haren, the Netherlands) receiving MFX 400 mg once daily as part of their TB treatment between January 1 2006 and January 1 2009. Safety data and drug–drug interactions were evaluated. Efficacy was predicted based on the area under the concentration–time curve up to 24 h post-dosage (AUC0–24h)/minimal inhibitory concentration (MIC) ratio. 89 patients were treated with a median dose of 6.9 mg·kg−1 MFX once daily for a median period of 74 days. Discontinuation of therapy occurred in only three patients due to gastrointestinal side-effects and hypersensitivity. Pharmacokinetic analysis showed an AUC0–24h/MIC ratio <100 in eight out of 16 patients. A large variation in protein binding affected the unbound AUC0–24h considerably. These data show that MFX treatment was well tolerated in 89 patients receiving a dose of 400 mg once daily for a prolonged period. Considering the variability in (un)bound AUC0–24h/MIC ratio, therapeutic drug monitoring is recommended in selected patients (i.e. rifampicin co-medication; MIC ≥0.25 mg·L−1) to assess optimal therapy.