Evaluation of Carbapenems for Treatment of Multi- and Extensively Drug-Resistant .

Multi- and extensively drug-resistant tuberculosis (M/XDR-TB) has become an increasing threat not only in countries where the TB burden is high but also in affluent regions, due to increased international travel and globalization. Carbapenems are earmarked as potentially active drugs for the treatment of To better understand the potential of carbapenems for the treatment of M/XDR-TB, the aim of this review was to evaluate the literature on currently available , , and clinical data on carbapenems in the treatment of and to detect knowledge gaps, in order to target future research. In February 2018, a systematic literature search of PubMed and Web of Science was performed.

Pharmacokinetics of ertapenem in patients with multidrug-resistant tuberculosis.

Treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) is becoming more challenging because of increased levels of drug resistance against second-line TB drugs. One promising group of antimicrobial drugs is carbapenems. Ertapenem is an attractive carbapenem for the treatment of MDR- and XDR-TB because its relatively long half-life enables once-daily dosing.

Pharmacokinetic Modeling and Optimal Sampling Strategies for Therapeutic Drug Monitoring of Rifampin in Patients with Tuberculosis.

Rifampin, together with isoniazid, has been the backbone of the current first-line treatment of tuberculosis (TB). The ratio of the area under the concentration-time curve from 0 to 24 h (AUC0-24) to the MIC is the best predictive pharmacokinetic-pharmacodynamic parameter for determinations of efficacy. The objective of this study was to develop an optimal sampling procedure based on population pharmacokinetics to predict AUC0-24 values.

Potential antimicrobial agents for the treatment of multidrug-resistant tuberculosis.

Treatment of multidrug-resistant (MDR) tuberculosis (TB) is challenging because of the high toxicity of second-line drugs and the longer treatment duration than for drug-susceptible TB patients. In order to speed up novel treatment for MDR-TB, we suggest considering expanding the indications of already available drugs. Six drugs with antimicrobial activity (phenothiazine, metronidazole, doxycycline, disulfiram, tigecycline and co-trimoxazole) are not listed in the World Health Organization guidelines on MDR-TB treatment but could be potential candidates for evaluation against Mycobacterium tuberculosis.

[Dysphagia in a young woman from Somalia].

Background: Multidrug-resistant tuberculosis is increasing worldwide. The determination of possible resistance is essential for adequate treatment. Tuberculosis is common amongst immigrants from Somalia and extra-pulmonary localisation is often seen.

Clarithromycin increases linezolid exposure in multidrug-resistant tuberculosis patients.

The use of linezolid for the treatment of multidrug-resistant tuberculosis is limited by dose- and time-dependent toxicity. Recently, we reported a case of pharmacokinetic drug-drug interaction between linezolid and clarithromycin that resulted in increased linezolid exposure. The aim of this prospective pharmacokinetic study is to quantify the effect of clarithromycin on the exposure of linezolid.

Evaluation of co-trimoxazole in the treatment of multidrug-resistant tuberculosis.

Co-trimoxazole (SXT), a combination of sulfamethoxazole and trimethoprim, has shown in vitro activity against Mycobacterium tuberculosis. However, the pharmacokinetic and pharmacodynamic parameters of SXT in multidrug-resistant (MDR) tuberculosis (TB) are, thus far, lacking. Therefore, we evaluated its pharmacokinetics and drug susceptibility, along with its tolerability during treatment.

Efficacy and safety of meropenem-clavulanate added to linezolid-containing regimens in the treatment of MDR-/XDR-TB.

Clinical experience on meropenem-clavulanate to treat tuberculosis (TB) is anecdotal (according to case reports on 10 patients). The aim of our case-control study was to evaluate the contribution of meropenem-clavulanate when added to linezolid-containing regimens in terms of efficacy and safety/tolerability in treating multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB cases after 3 months of second-line treatment. 37 cases with MDR-/XDR-TB were prescribed meropenem-clavulanate (3 g daily dose) in addition to a linezolid-containing regimen (dosage range 300-1200 mg·day(-1)), designed according to international guidelines, which was prescribed to 61 controls.

Immunology in tuberculosis: challenges in monitoring of disease activity and identifying correlates of protection.

Humans have always lived with tubercle bacilli. Host susceptibility both inherited and acquired determines whether an individual infected with Mycobacterium tuberculosis will eventually fall ill and develop tuberculosis (TB). After infection with M.

Limited-sampling strategies for therapeutic drug monitoring of moxifloxacin in patients with tuberculosis.

Background: Moxifloxacin (MFX) is a potent drug for multidrug resistant tuberculosis(TB) treatment and is also useful if first-line agents are not tolerated. Therapeutic drug monitoring may help to prevent treatment failure. Obtaining a full concentration-time curve of MFX for therapeutic drug monitoring is not feasible in most settings.

[Practice guideline prevention, diagnosis and treatment of tuberculosis in patients with an HIV infection].

An interdisciplinary workgroup from the National Committee for Practical Tuberculosis Control in the Netherlands has written an evidence-based practice guideline on the prevention, diagnosis, and treatment of HIV-infected patients with active tuberculosis or latent tuberculosis infection. The diagnosis and treatment of tuberculosis are effectively the same in patients with or without an HIV infection. The diagnosis is more complex in a patient with an HIV infection due to the effect of the immunodeficiency on diagnostic parameters.

Weight loss during tuberculosis treatment is an important risk factor for drug-induced hepatotoxicity.

The objective of this study was to determine the association between weight loss and drug-induced hepatotoxicity (DIH). A retrospective observational study of 192 active tuberculosis (TB) patients consecutively admitted in a tertiary referral TB centre in the Netherlands was conducted. The outcome measure for DIH was defined as hepatotoxicity necessitating interruption of anti-TB drugs.

Comparison of the pharmacokinetics of two dosage regimens of linezolid in multidrug-resistant and extensively drug-resistant tuberculosis patients.

Background And Objectives: For the treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB), potent new drugs are urgently needed. Linezolid is a promising drug, but its use is limited by adverse effects with prolonged administration of 600 mg twice daily. In order to reduce its adverse effects and maintain efficacy, we investigated whether linezolid in a reduced dosage resulted in drug serum concentrations exceeding a ratio of the in vitro minimum inhibitory concentration (MIC) to the area under the serum concentration-time curve (AUC) over 24 hours (AUC(24)) [AUC(24)/MIC] of >100.

Limited sampling strategies for therapeutic drug monitoring of linezolid in patients with multidrug-resistant tuberculosis.

Introduction: Linezolid is a potential drug for the treatment of multidrug-resistant tuberculosis but its use is limited because of severe adverse effects such as anemia, thrombocytopenia, and peripheral neuropathy. This study aimed to develop a model for the prediction of linezolid area under the plasma concentration-time curve from 0 to 12 hours (AUC0-12h) by limited sampling strategy to enable individualized dosing.

Patients And Methods: Fourteen patients with multidrug-resistant tuberculosis received linezolid twice daily as part of their antituberculosis treatment.

[Practice guideline prevention, diagnosis and treatment of tuberculosis in patients with an HIV infection].

An interdisciplinary workgroup from the National Committee for Practical Tuberculosis Control in the Netherlands has written an evidence-based practice guideline on the prevention, diagnosis, and treatment of HIV-infected patients with active tuberculosis or latent tuberculosis infection. The diagnosis and treatment of tuberculosis are effectively the same in patients with or without an HIV infection. The diagnosis is more complex in a patient with an HIV infection due to the effect of the immunodeficiency on diagnostic parameters.

Prediction of deformity in spinal tuberculosis.

Tuberculosis of the spine may cause kyphosis, which may in turn cause late paraplegia, respiratory compromise, and unsightly deformity. Surgical correction therefore may be considered for large or progressive deformities. We retrospectively analyzed clinical and radiographic parameters to predict the final kyphotic angle in spinal tuberculosis and to identify patients at risk of unfavorable outcomes at an early stage of the disease when surgery may be indicated.

Causes of misdiagnosis and mistreatment of spinal tuberculosis with radiotherapy in nonendemic areas: a pitfall in diagnosis and treatment: hazards of radiotherapy on the tuberculous lesion.

Study Design: Report of initially misdiagnosed and mistreated cases.

Objectives: To report a previously undescribed misdiagnosis and subsequent mistreatment with radiation for tuberculosis of the spine and to promote awareness for tuberculosis in nonendemic areas.

Summary Of Background Data: It is not seldom that radiation therapy is provided for suspected malignant spinal lesions without histologic confirmation.