Publication

Evaluation of saliva as a potential alternative sampling matrix for therapeutic drug monitoring of levofloxacin in patients with multidrug-resistant tuberculosis

Ghimire, S., Maharjan, B., Jongedijk, E. M., Kosterink, J. G. W., Ghimire, G. R., Touw, D. J., van der Werf, T. S., Shrestha, B. & Alffenaar, J. W. C., 1-May-2019, In : Antimicrobial Agents and Chemotherapy. 63, 5, 10 p., ARTN e02379-18.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Ghimire, S., Maharjan, B., Jongedijk, E. M., Kosterink, J. G. W., Ghimire, G. R., Touw, D. J., ... Alffenaar, J. W. C. (2019). Evaluation of saliva as a potential alternative sampling matrix for therapeutic drug monitoring of levofloxacin in patients with multidrug-resistant tuberculosis. Antimicrobial Agents and Chemotherapy, 63(5), [ARTN e02379-18]. https://doi.org/10.1128/AAC.02379-1

Author

Ghimire, Samiksha ; Maharjan, Bhagwan ; Jongedijk, Erwin M. ; Kosterink, Jos G.W. ; Ghimire, Gokarna R. ; Touw, Daan J. ; van der Werf, Tjip S. ; Shrestha, Bhabana ; Alffenaar, Jan Willem C. / Evaluation of saliva as a potential alternative sampling matrix for therapeutic drug monitoring of levofloxacin in patients with multidrug-resistant tuberculosis. In: Antimicrobial Agents and Chemotherapy. 2019 ; Vol. 63, No. 5.

Harvard

Ghimire, S, Maharjan, B, Jongedijk, EM, Kosterink, JGW, Ghimire, GR, Touw, DJ, van der Werf, TS, Shrestha, B & Alffenaar, JWC 2019, 'Evaluation of saliva as a potential alternative sampling matrix for therapeutic drug monitoring of levofloxacin in patients with multidrug-resistant tuberculosis', Antimicrobial Agents and Chemotherapy, vol. 63, no. 5, ARTN e02379-18. https://doi.org/10.1128/AAC.02379-1

Standard

Evaluation of saliva as a potential alternative sampling matrix for therapeutic drug monitoring of levofloxacin in patients with multidrug-resistant tuberculosis. / Ghimire, Samiksha; Maharjan, Bhagwan; Jongedijk, Erwin M.; Kosterink, Jos G.W.; Ghimire, Gokarna R.; Touw, Daan J.; van der Werf, Tjip S.; Shrestha, Bhabana; Alffenaar, Jan Willem C.

In: Antimicrobial Agents and Chemotherapy, Vol. 63, No. 5, ARTN e02379-18, 01.05.2019.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Ghimire S, Maharjan B, Jongedijk EM, Kosterink JGW, Ghimire GR, Touw DJ et al. Evaluation of saliva as a potential alternative sampling matrix for therapeutic drug monitoring of levofloxacin in patients with multidrug-resistant tuberculosis. Antimicrobial Agents and Chemotherapy. 2019 May 1;63(5). ARTN e02379-18. https://doi.org/10.1128/AAC.02379-1


BibTeX

@article{eb843d23269d450290c53ba1ee4b7b17,
title = "Evaluation of saliva as a potential alternative sampling matrix for therapeutic drug monitoring of levofloxacin in patients with multidrug-resistant tuberculosis",
abstract = "Saliva may be a useful alternative matrix for monitoring levofloxacin concentrations in multidrug-resistant tuberculosis (MDR-TB) patients. The objectives of this study were (i) to evaluate the correlation between plasma and salivary levofloxacin (Lfx) concentrations in MDR-TB patients and (ii) to gauge the possibility of using saliva as an alternative sampling matrix for therapeutic drug monitoring of Lfx in areas where TB is endemic. This was a prospective pharmacokinetic study that enrolled MDR-TB patients receiving levofloxacin (750- to 1,000-mg once-daily dosing) under standardized treatment regimen in Nepal. Paired blood and saliva samples were collected at steady state. Lfx concentrations were quantified using liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were calculated using noncompartmental kinetics. Lfx drug exposures were evaluated in 23 MDR-TB patients. During the first month, the median (interquartile range [IQR]) areas under the concentration-time curve from 0 to 24 h (AUC 0–24 ) were 67.09 (53.93 to 98.37) mg ⋅ h/liter in saliva and 99.91 (76.80 to 129.70) mg ⋅ h/liter in plasma, and the saliva plasma (S/P) ratio was 0.69 (0.53 to 0.99). Similarly, during the second month, the median (IQR) AUC 0–24 were 75.63 (61.45 to 125.5) mg ⋅ h/liter in saliva and 102.7 (84.46 to 131.9) mg ⋅ h/liter in plasma, with an S/P ratio of 0.73 (0.66 to 1.18). Furthermore, large inter- and intraindividual variabilities in Lfx concentrations were observed. This study could not demonstrate a strong correlation between plasma and saliva Lfx levels. Despite a good Lfx penetration in saliva, the variability in individual saliva-to-plasma ratios limits the use of saliva as a valid substitute for plasma. Nevertheless, saliva could be useful in semiquantitatively predicting Lfx plasma levels. (This study has been registered at ClinicalTrials.gov under identifier NCT03000517.)",
keywords = "Levofloxacin, Pharmacokinetics, Plasma, Saliva, Tuberculosis",
author = "Samiksha Ghimire and Bhagwan Maharjan and Jongedijk, {Erwin M.} and Kosterink, {Jos G.W.} and Ghimire, {Gokarna R.} and Touw, {Daan J.} and {van der Werf}, {Tjip S.} and Bhabana Shrestha and Alffenaar, {Jan Willem C.}",
year = "2019",
month = "5",
day = "1",
doi = "10.1128/AAC.02379-1",
language = "English",
volume = "63",
journal = "Antimicrobial Agents and Chemotherapy",
issn = "1098-6596",
publisher = "AMER SOC MICROBIOLOGY",
number = "5",

}

RIS

TY - JOUR

T1 - Evaluation of saliva as a potential alternative sampling matrix for therapeutic drug monitoring of levofloxacin in patients with multidrug-resistant tuberculosis

AU - Ghimire, Samiksha

AU - Maharjan, Bhagwan

AU - Jongedijk, Erwin M.

AU - Kosterink, Jos G.W.

AU - Ghimire, Gokarna R.

AU - Touw, Daan J.

AU - van der Werf, Tjip S.

AU - Shrestha, Bhabana

AU - Alffenaar, Jan Willem C.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Saliva may be a useful alternative matrix for monitoring levofloxacin concentrations in multidrug-resistant tuberculosis (MDR-TB) patients. The objectives of this study were (i) to evaluate the correlation between plasma and salivary levofloxacin (Lfx) concentrations in MDR-TB patients and (ii) to gauge the possibility of using saliva as an alternative sampling matrix for therapeutic drug monitoring of Lfx in areas where TB is endemic. This was a prospective pharmacokinetic study that enrolled MDR-TB patients receiving levofloxacin (750- to 1,000-mg once-daily dosing) under standardized treatment regimen in Nepal. Paired blood and saliva samples were collected at steady state. Lfx concentrations were quantified using liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were calculated using noncompartmental kinetics. Lfx drug exposures were evaluated in 23 MDR-TB patients. During the first month, the median (interquartile range [IQR]) areas under the concentration-time curve from 0 to 24 h (AUC 0–24 ) were 67.09 (53.93 to 98.37) mg ⋅ h/liter in saliva and 99.91 (76.80 to 129.70) mg ⋅ h/liter in plasma, and the saliva plasma (S/P) ratio was 0.69 (0.53 to 0.99). Similarly, during the second month, the median (IQR) AUC 0–24 were 75.63 (61.45 to 125.5) mg ⋅ h/liter in saliva and 102.7 (84.46 to 131.9) mg ⋅ h/liter in plasma, with an S/P ratio of 0.73 (0.66 to 1.18). Furthermore, large inter- and intraindividual variabilities in Lfx concentrations were observed. This study could not demonstrate a strong correlation between plasma and saliva Lfx levels. Despite a good Lfx penetration in saliva, the variability in individual saliva-to-plasma ratios limits the use of saliva as a valid substitute for plasma. Nevertheless, saliva could be useful in semiquantitatively predicting Lfx plasma levels. (This study has been registered at ClinicalTrials.gov under identifier NCT03000517.)

AB - Saliva may be a useful alternative matrix for monitoring levofloxacin concentrations in multidrug-resistant tuberculosis (MDR-TB) patients. The objectives of this study were (i) to evaluate the correlation between plasma and salivary levofloxacin (Lfx) concentrations in MDR-TB patients and (ii) to gauge the possibility of using saliva as an alternative sampling matrix for therapeutic drug monitoring of Lfx in areas where TB is endemic. This was a prospective pharmacokinetic study that enrolled MDR-TB patients receiving levofloxacin (750- to 1,000-mg once-daily dosing) under standardized treatment regimen in Nepal. Paired blood and saliva samples were collected at steady state. Lfx concentrations were quantified using liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were calculated using noncompartmental kinetics. Lfx drug exposures were evaluated in 23 MDR-TB patients. During the first month, the median (interquartile range [IQR]) areas under the concentration-time curve from 0 to 24 h (AUC 0–24 ) were 67.09 (53.93 to 98.37) mg ⋅ h/liter in saliva and 99.91 (76.80 to 129.70) mg ⋅ h/liter in plasma, and the saliva plasma (S/P) ratio was 0.69 (0.53 to 0.99). Similarly, during the second month, the median (IQR) AUC 0–24 were 75.63 (61.45 to 125.5) mg ⋅ h/liter in saliva and 102.7 (84.46 to 131.9) mg ⋅ h/liter in plasma, with an S/P ratio of 0.73 (0.66 to 1.18). Furthermore, large inter- and intraindividual variabilities in Lfx concentrations were observed. This study could not demonstrate a strong correlation between plasma and saliva Lfx levels. Despite a good Lfx penetration in saliva, the variability in individual saliva-to-plasma ratios limits the use of saliva as a valid substitute for plasma. Nevertheless, saliva could be useful in semiquantitatively predicting Lfx plasma levels. (This study has been registered at ClinicalTrials.gov under identifier NCT03000517.)

KW - Levofloxacin

KW - Pharmacokinetics

KW - Plasma

KW - Saliva

KW - Tuberculosis

U2 - 10.1128/AAC.02379-1

DO - 10.1128/AAC.02379-1

M3 - Article

VL - 63

JO - Antimicrobial Agents and Chemotherapy

JF - Antimicrobial Agents and Chemotherapy

SN - 1098-6596

IS - 5

M1 - ARTN e02379-18

ER -

ID: 91992571