Therapeutic Drug Monitoring Practice In Patients With Active Tuberculosis: Assessment Of Opportunities

Recently updated World Health Organisation (WHO) and American Thoracic Society (ATS) guidelines include recommendations for therapeutic drug monitoring (TDM) during treatment for Mycobacterium tuberculosis (TB) in patients at risk of altered drug exposure or poor prognosis [1, 2]. Sub-optimal drug exposure may be associated with acquired resistance and poor treatment outcomes [3] whereas supra-therapeutic concentrations may lead to toxicity. TDM is indicated in patients at risk of altered pharmacokinetics ( e.g. HIV, diabetes mellitus, gastrointestinal abnormalities, drug-drug interactions, renal impairment) and/or worsened treatment prognosis (inadequate treatment response despite adherence or on second line drugs, especially for fluoroquinolones, linezolid and aminoglycosides) [1, 2, 4].\n\nFootnotes \n\nThis manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.\n\nConflict of interest: Dr. KIM has nothing to disclose.\n\nConflict of interest: Mr. Ulbricht has nothing to disclose.\n\nConflict of interest: Dr. Ahn has nothing to disclose.\n\nConflict of interest: Dr. Cho has nothing to disclose.\n\nConflict of interest: Lee has nothing to disclose.\n\nConflict of interest: Dr. Lieu has nothing to disclose.\n\nConflict of interest: Dr. Nguyen has nothing to disclose.\n\nConflict of interest: Dr. Young has nothing to disclose.\n\nConflict of interest: Dr. Cho has nothing to disclose.\n\nConflict of interest: Dr. Alffenaar has nothing to disclose.