TY - JOUR T1 - Dose optimisation of first-line tuberculosis drugs using therapeutic drug monitoring in saliva: feasible for rifampicin, not for isoniazid JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00803-2020 VL - 56 IS - 4 SP - 2000803 AU - Simone H.J. van den Elsen AU - Onno W. Akkerman AU - Mireille Wessels AU - Erwin M. Jongedijk AU - Samiksha Ghimire AU - Tjip S. van der Werf AU - Mathieu S. Bolhuis AU - Daan J. Touw AU - Jan-Willem C. Alffenaar Y1 - 2020/10/01 UR - http://erj.ersjournals.com/content/56/4/2000803.abstract N2 - The persisting worldwide burden of tuberculosis (TB) is worrisome. In 2018, an estimated 10 million individuals developed TB and 1.45 million infected individuals died [1]. The increase in drug resistance is an important point of concern. Resistance can be acquired by inappropriate drug management, noncompliance and insufficient drug exposure [2, 3]. The last is frequently described for the first-line TB drugs rifampicin and isoniazid due to large interindividual pharmacokinetic variability [3]. Therapeutic drug monitoring (TDM) can be used to verify drug exposure and adjust individual drug dosages if needed [4].Therapeutic drug monitoring using saliva samples is feasible for rifampicin, despite low penetration, but is not feasible for isoniazid, which showed inexplicable highly variable saliva/serum concentration ratios https://bit.ly/2yAS2Jc ER -