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Pharmacokinetics of ethambutol in children and adults with tuberculosis.
Zhu, M; Burman, W J; Starke, J R; Stambaugh, J J; Steiner, P; Bulpitt, A E; Ashkin, D; Auclair, B; Berning, S E; Jelliffe, R W; Jaresko, G S; Peloquin, C A.
Afiliação
  • Zhu M; Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado 80206, USA.
Int J Tuberc Lung Dis ; 8(11): 1360-7, 2004 Nov.
Article em En | MEDLINE | ID: mdl-15581206
SETTING: Five hospitals in the United States. OBJECTIVE: To describe ethambutol pharmacokinetics in children and adults with active tuberculosis (TB). DESIGN: Prospective, open-labeled study in 56 adults and 14 children with active tuberculosis who received ethambutol as part of their multidrug TB regimens. RESULTS: Most serum samples were collected up to 10 h post dose and assayed using a validated gas chromatography assay with mass selective detection (GC/MS). Concentration data were analyzed using non-compartmental and population pharmacokinetic methods. Drug exposure increased with dose, but less than proportionally at doses >3000 mg. Lower than expected maximum serum concentrations (Cmax <2 microg/ml) were common in adults. Very low Cmax (<1 microg/ml) were common in children, as was delayed absorption (time to Cmax >3 h). Many Cmax were at or below typical TB minimal inhibitory concentrations. Cmax values for HIV-positive patients were 20% lower than HIV-negative patients with daily doses, but were similar with larger twice-weekly doses. CONCLUSIONS: Adult TB patients often had lower than expected ethambutol serum concentrations, and most pediatric TB patients had very low ethambutol serum concentrations. Higher doses and therapeutic drug monitoring may be indicated for many of these patients.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose Pulmonar / Etambutol / Antituberculosos Tipo de estudo: Prognostic_studies Limite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Int J Tuberc Lung Dis Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose Pulmonar / Etambutol / Antituberculosos Tipo de estudo: Prognostic_studies Limite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Int J Tuberc Lung Dis Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Estados Unidos