Abstract
Concomitant use of clarithromycin (CAM) and rifampicin (RFP) for the treatment of pulmonary Mycobacterium avium complex (MAC) disease affects the systemic concentrations of both drugs due to CYP3A4-related interactions. To date, however, there has been no report that investigates the long-term relationship between the drug concentrations, CYP3A4 activity, and clinical outcomes. Our aim was to investigate the time course of the drug levels in long-term treatment of subjects with pulmonary MAC disease, and examine the correlation of these concentrations with CYP3A4 activity and clinical outcomes. Urine and blood samples from nine outpatients with pulmonary MAC disease were collected on days 1, 15, and 29 (for four subjects, sample collections were continued on days 57, 85, 113, 141, 169, 225, 281, 337, and 365). Serum drug concentrations and urinary levels of endogenous cortisol (F) and 6 beta-hydroxycortisol (6βOHF), the metabolite of F by CYP3A4, were measured, and evaluated 6βOHF/F ratio as a CYP3A4 activity marker. In addition, the clinical outcomes of 4 subjects were evaluated based on examination of sputum cultures and chest images. The mean 6βOHF/F ratio increased from 2.63 ± 0.85 (n = 9) on the first day to 6.96 ± 1.35 on...Continue Reading
References
Mar 20, 1985·Nihon Naibunpi Gakkai zasshi·S Kawai
Mar 1, 1995·The Journal of Infectious Diseases·R J WallaceK Tanaka
Jun 1, 1993·Antimicrobial Agents and Chemotherapy·N Mor, L Heifets
Jan 1, 1993·Antimicrobial Agents and Chemotherapy·N Mor, L Heifets
Jun 1, 1996·American Journal of Respiratory and Critical Care Medicine·R J WallaceD T Murphy
Aug 8, 1998·Clinical Pharmacology and Therapeutics·H WakasugiK Inui
Sep 3, 1999·American Journal of Respiratory and Critical Care Medicine·E TanakaF Kuze
Mar 4, 2003·Thorax·A M MiddletonR Wilson
Aug 11, 2004·Chest·Stephen K FieldRobert L Cowie
Sep 27, 2005·Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences·Zheyi HuZeneng Cheng
Dec 9, 2008·Pulmonary Pharmacology & Therapeutics·Naoki HasegawaAkitoshi Ishizaka
Jan 27, 2009·International Journal of Clinical Practice·E E McGrathUNKNOWN Infectious Diseases Society of America
Jun 30, 2010·Antimicrobial Agents and Chemotherapy·J W C AlffenaarT S van der Werf
Feb 12, 2011·Journal of Pharmaceutical and Biomedical Analysis·Stefan OswaldWerner Siegmund
Mar 26, 2011·The Korean Journal of Internal Medicine·Eun Young KimYong Soo Kwon
Aug 23, 2011·Biochemical Pharmacology·Akinori NakajimaTsuyoshi Yokoi
Jan 19, 2012·Antimicrobial Agents and Chemotherapy·Wynand SmytheUlrika S H Simonsson
May 26, 2012·Chest·Won-Jung KohO Jung Kwon
Aug 11, 2012·American Journal of Respiratory and Critical Care Medicine·Won-Jung KohSung Jae Shin
Jan 25, 2014·Chest·Richard J WallaceDavid E Griffith
Nov 5, 2014·Tuberculosis and Respiratory Diseases·Cheol Kyu Park, Yong Soo Kwon