TB therapeutic drug monitoring – analysis of opportunities in Romania and Ukraine

Margineanu, I., Butnaru, T., Gafar, F., Baiceanu, D., Dragomir, R., Semianiv, I., Mihaltan, F., Munteanu, I., Mahler, B., Todoriko, L., Margineanu, S., Akkerman, O., Stienstra, Ymkje and Alffenaar, J-W. C. (2023) 'TB therapeutic drug monitoring – analysis of opportunities in Romania and Ukraine'. The International Journal of Tuberculosis and Lung Disease, Vol 27, Issue 11, pp. 816-821.

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Abstract

INTRODUCTION:
Therapeutic drug monitoring (TDM) could improve TB treatment outcomes by avoiding drug toxicity or underdosing. In this study, we describe the patient burden in three TB centres in Romania and Ukraine with a TDM indication, as per the current guidelines, in order to estimate the feasibility of implementing TDM.

METHODS:
A retrospective multi-centre study was conducted at the Iasi Lung Hospital (Iasi, Romania), Bucharest Marius Nasta Institute (Bucharest, Romania) and Chernivtsi TB Centre (Chernivtsi, Ukraine) in adult hospitalised TB patients.

RESULTS:
A total of 927 participants were admitted, of whom 37.8% had at least one indication for TDM, the most frequent being slow response to TB treatment (202/345, 58.6%); 55.5% had at least one cavity present on chest X-ray. Patients with a TDM indication stayed in the hospital for a median of 67 days and took on average 2 months more to reach a successful TB outcome.

CONCLUSION:
TDM could be a valuable tool to improve management of selected TB patients. The decision on whether to perform TDM is often delayed by 2 months due to waiting for culture results after treatment initiation. A randomised control trial should be performed in order to define TDM’s precise role in TB therapy.

Item Type:	Article
Subjects:	WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.5588/ijtld.22.0667
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	12 Feb 2024 11:27
Last Modified:	12 Feb 2024 11:27
URI:	https://archive.lstmed.ac.uk/id/eprint/23417

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