Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Int J Tuberc Lung Dis. 2011 Jul;15(7):990-2. doi: 10.5588/ijtld.10.0127.
In an outbreak of multidrug-resistant tuberculosis, the outbreak strain had an Asp516Tyr rpoB gene mutation. Phenotypically, low-level rifampicin (RMP) resistance (minimum inhibitory concentration [MIC] 1-2 mg/l) was observed. Based on drug susceptibility test results, three patients were treated with 12-15 month rifabutin-based regimens and one with a 12-month RMP-based regimen. We retrospectively performed pharmacokinetic calculations to assess the potential for RMP treatment, from which we conclude that MICs for RMP up to 1 μg/ml may be safely overcome by applying 20 mg/kg RMP doses in treatment regimens.
在耐多药结核病爆发中，暴发菌株具有 rpoB 基因 Asp516Tyr 突变。表型上，观察到低水平利福平（RMP）耐药（最低抑菌浓度 [MIC] 1-2 mg/l）。根据药敏试验结果，3 名患者接受了 12-15 个月的利福布汀为基础的方案治疗，1 名患者接受了 12 个月的 RMP 为基础的方案治疗。我们回顾性地进行了药代动力学计算，以评估 RMP 治疗的潜力，从中我们得出结论，在治疗方案中应用 20mg/kg RMP 剂量，可能可以安全地克服 RMP 浓度高达 1μg/ml 的 MIC。
