Therapeutic drug monitoring using saliva as matrix: an opportunity for linezolid, but challenge for moxifloxacin
Therapeutic drug monitoring using saliva as matrix: an opportunity for linezolid, but challenge for moxifloxacin
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以唾液为基质的治疗药物监测：利奈唑胺的机遇，莫西沙星的挑战
DOI：
10.1183/13993003.01903-2019
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发表时间：
2020
影响因子：
24.3
通讯作者：
J. Alffenaar
中科院分区：
文献类型：
--
作者：
Simone H. J. van den Elsen;O. Akkerman;Erwin M. Jongedijk;Mireille A. Wessels;S. Ghimire;T. S. van der Werf;D. Touw;M. Bolhuis;J. Alffenaar
世界卫生组织（WHO）已将阿氟沙星和利奈唑胺列为治疗耐多药（MDR）结核病（TB）的首选“A组”药物[1]。治疗药物监测（TDM）可能会优化MDR-TB治疗，因为诺氟沙星和利奈唑胺显示出较大的药代动力学变异性[1-4]。利福沙星的TDM侧重于识别低药物暴露的患者，这些患者存在治疗失败和获得性氟喹诺酮类耐药的风险[5，6]。或者，利奈唑胺的TDM努力降低毒性，同时确保充分的药物暴露，因为其治疗指数较窄[1，3，7]。使用唾液作为基质的治疗药物监测是利奈唑胺血清治疗药物监测的合适替代方案，但由于唾液-血浆比的高度变异性，因此不适用于利奈沙星。http://bit.ly/2NIYdz7
The World Health Organization (WHO) has listed moxifloxacin and linezolid among the preferred “group A” drugs in the treatment of multidrug-resistant (MDR)-tuberculosis (TB) [1]. Therapeutic drug monitoring (TDM) could potentially optimise MDR-TB therapy, since moxifloxacin and linezolid show large pharmacokinetic variability [1–4]. TDM of moxifloxacin focuses on identifying patients with low drug exposure who are at risk of treatment failure and acquired fluoroquinolone resistance [5, 6]. Alternatively, TDM of linezolid strives to reduce toxicity while ensuring an adequate drug exposure because of its narrow therapeutic index [1, 3, 7]. Therapeutic drug monitoring using saliva as matrix is a suitable alternative for serum therapeutic drug monitoring of linezolid, but not for moxifloxacin due to a high variability in saliva-plasma ratios http://bit.ly/2NIYdz7