Effect of rifampicin & isoniazid on the steady state pharmacokinetics of moxifloxacin.

BACKGROUND & OBJECTIVES: Moxifloxacin (MFX) is reported to have promising antimycobacterial activity, and has a potential to shorten tuberculosis (TB) treatment. We undertook this study to examine the influence of rifampicin (RMP) and isoniazid (INH) on the steady state pharmacokinetics of MFX individually in healthy individuals. METHODS: A baseline pharmacokinetic study of MFX (400 mg once daily) was conducted in 36 healthy adults and repeated after one week of daily MFX with either RMP (450/600 mg) (n = 18) or INH (300 mg) (n = 18). Plasma MFX concentrations were determined by a validated HPLC method. RESULTS: Plasma peak concentration and exposure of MFX was significantly lower and plasma clearance significantly higher when combined with RMP (P<0.001). The C max to MIC and AUC 0-12 to MIC ratios of MFX were significantly lower during concomitant RMP (P<0.001). INH had no significant effect on the pharmacokinetics of MFX. INTERPRETATION & CONCLUSIONS: Concomitant RMP administration caused a significant decrease in C max and AUC 0-12 of MFX, the mean decreases being 26 and 29 per cent, respectively. It is uncertain whether this decrease would affect the treatment efficacy of MFX. Prospective studies in TB patients are needed to correlate MFX pharmacokinetics with treatment outcomes.

Study of the knowledge, beliefs, and practice of sleep among medical undergraduates of Tamilnadu, India.

CONTEXT: Sleep-related problems are common in young adults who are enrolled in professional colleges due to academic and social pressures, which may subsequently have serious consequences. OBJECTIVES: This study was conducted to find out whether final-year medical undergraduates possess basic, clinically relevant knowledge (K) regarding sleep and sleep-related problems and to discover their beliefs (B) regarding sleep and sleep hygiene. We also wanted to assess their sleep practices (P) and suggest remedial measures, if necessary. DESIGN AND SETTING: Six hundred fifteen final-year medical undergraduates of both sexes belonging to 6 medical colleges of Tamilnadu state, India, were given a self-administered, anonymous questionnaire to test their basic knowledge (11 items), prevailing beliefs regarding sleep (including sleep hygiene [13 items]), and their sleep practices (6 items). RESULTS: In all 3 domains tested (K, B, and P), there was no significant difference between sex. An appreciable percentage scored < or = 70% marks ("good") only in K and P (63.9% and 79.5% of all participants, respectively), whereas only a very small percentage scored "good" in B (9.1%). There was no difference in K, B, or P in terms of sex or domiciliary status except for a significant difference (P < .012) regarding beliefs between urban and rural groups. There was also no correlation between knowledge and beliefs or between knowledge and practice. CONCLUSION: We conclude that future doctors have insufficient knowledge with more misconceptions (indirectly reflecting inadequate knowledge) regarding sleep. Hence, there is a compelling need to develop an educational strategy to overcome misconceptions and improve knowledge regarding sleep-related problems and proper sleep practices among students.