Early Therapeutic Drug Monitoring for Isoniazid and Rifampin among Diabetics with Newly Diagnosed Tuberculosis in Virginia, USA. (17th November 2013)

• Record Type: Journal Article
• Authors: Heysell, Scott K.; Moore, Jane L.; Staley, Debbie; Dodge, Denise; Houpt, Eric R.
• Other Names: Ottenhoff T. Academic Editor.
• Is Part Of: Tuberculosis research and treatment. Volume 2013(2013)
• Publication Date: 2013-11-17
• Subjects: Tuberculosis -- Periodicals; Tuberculosis -- Prevention -- Periodicals; Tuberculosis -- Treatment -- Periodicals; Tuberculosis -- Social aspects -- Periodicals; 616.995005
• DOI: 10.1155/2013/129723
• Languages: English
• ISSNs: 2090-150X

Abstract

Abstract : Slow responders to tuberculosis (TB) treatment in Virginia have prolonged treatment duration and consume more programmatic resources. Diabetes is an independent risk factor for slow response and low serum anti-TB drug concentrations. Thus, a statewide initiative of early therapeutic drug monitoring (TDM) for isoniazid and rifampin at 2 weeks after TB treatment was piloted for all diabetics with newly diagnosed TB. During the period of early TDM, 12/01/2011–12/31/2012, 21 diabetics had C 2 h r concentrations performed and 16 (76%) had a value below the expected range for isoniazid, rifampin, or both. Fifteen had follow-up concentrations after dose adjustment and 12 (80%) increased to within the expected range (including all for rifampin). Of 16 diabetic patients with pulmonary TB that had early TDM, 14 (88%) converted their sputum culture to negative in <2 months. Early TDM for diabetics was operationally feasible, may speed response to TB therapy, and can be considered for TB programs with high diabetes prevalence.