AI Article Synopsis
- - The study examines tuberculosis (TB) patients in intensive care, finding that they have high mortality rates (up to 78%) possibly due to low drug levels in their systems compared to outpatients.
- - Researchers compared the pharmacokinetics (how drugs move through the body) of common TB medications in ICU patients versus outpatients, discovering that ICU patients had lower drug clearance and volume distribution.
- - The lower drug effectiveness in ICU patients may be linked to organ function changes and poor drug absorption, which could contribute to their higher death rates compared to outpatients who had a much higher cure rate (89%).
Article Abstract
Background: Patients with tuberculosis (TB) may develop multi-organ failure and require admission to intensive care. In these cases, the mortality rates are as high as 78% and may be caused by suboptimal serum concentrations of first-line TB drugs. This study aims to compare the pharmacokinetics of oral rifampin, isoniazid, pyrazinamide and ethambutol patients in intensive care units (ICU) to outpatients and to evaluate drug serum concentrations as a potential cause of mortality.
Methods: A prospective pharmacokinetic (PK) study was performed in Amazonas State, Brazil. The primary PK parameters of outpatients who achieved clinical and microbiological cure were used as a comparative target in a non-compartmental analysis.
Results: Thirteen ICU and twenty outpatients were recruited. The clearance and volume of distribution were lower for rifampin, isoniazid, pyrazinamide and ethambutol. ICU thirty-day mortality was 77% versus a cure rate of 89% in outpatients.
Conclusions: ICU patients had a lower clearance and volume of distribution for rifampin, isoniazid, pyrazinamide and ethambutol compared to the outpatient group. These may reflect changes to organ function, impeded absorption and distribution to the site of infection in ICU patients and have the potential to impact clinical outcomes.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10303681 | PMC |
| http://dx.doi.org/10.3390/tropicalmed8060312 | DOI Listing |
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