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Exposure to Rifampicin Is Strongly Reduced in Patients with Tuberculosis and Type 2 Diabetes.
- Source :
-
Clinical Infectious Diseases . 10/1/2006, Vol. 43 Issue 7, p848-854. 7p. - Publication Year :
- 2006
-
Abstract
- Background. Type 2 diabetes (DM) is a strong risk factor for tuberculosis (TB) and is associated with a slower response to TB treatment and a higher mortality rate. Because lower concentrations of anti-TB drugs may be a contributing factor, we compared the pharmacokinetics of rifampicin in patients with TB, with and without DM. Methods. Seventeen adult Indonesian patients with TB and DM and 17 age- and sex-matched patients with TB and without DM were included in the study during the continuation phase of TB treatment. All patients received 450 mg of rifampicin (10 mg/kg) and 600 mg of isoniazid 3 times weekly. Steady-state plasma concentrations of rifampicin and its metabolite desacetylrifampicin were assessed at 0, 2, 4, and 6 h after drug intake. Results. Geometric means of rifampicin exposure (AUC0–6 h) were 12.3 mg × h/L (95% confidence interval [CI], 8.0–24.2) in patients with TB and DM, and 25.9 mg × h/L (95% Cl, 21.4–40.2) in patients with TB only (P = .003). Similar differences were found for the maximum concentration of rifampicin. No significant differences in time to maximum concentration of rifampicin were observed. The AUC0–6 h of desacetylrifampicin was also much lower in patients with TB and DM versus patients with TB only (geometric mean, 0.60 vs. 3.2 mg × h/L; P = .001). Linear regression analysis revealed that higher body weight (P < .001), the presence of DM (P = .06), and plasma glucose concentration (P =.016) were correlated with exposure to rifampicin. Conclusion. Exposure (AUC0–6 h) to rifampicin was 53% lower in Indonesian patients with TB and DM, compared with patients with TB only. Patients with TB and DM who have a higher body weight may need a higher dose of rifampicin. [ABSTRACT FROM AUTHOR]
- Subjects :
- *RIFAMPIN
*TUBERCULOSIS diagnosis
*DIABETES
*METABOLITES
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 43
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 22251022
- Full Text :
- https://doi.org/10.1086/507543