The Application of the Therapeutic Drug Monitoring (TDM) of First and Second-Line Drugs for Multidrug- Resistant Tuberculosis Patients (MDRTB)

Abstract

Objective: The study aimed to evaluate the effectiveness, safety, and drug compliance among MDRTB-patients who either undergo therapeutic drug monitoring (TDM) or not to assess the full benefit of TDM related to the disease treatment. Methods: It was a quasi-experimental design. The study group underwent TDM process to measure serum drug concentrations of pyrazinamide (PZA) and cycloserine (CS), whereas the control group went through the regular process of treatment without taking TDM. All patient information and lab tests were investigated. Descriptive statistics including, frequency, percentage, mean, SD, percentage (s) as well as analytical statistics at confidence interval of 95% (p.05). Overall, the treatment success of MDR-TB among the subjects in both groups were still not satisfied. The common side effects of both medications were reported. Serum concentrations of PZA and cylcoserine were not significantly related to the side effects. Similarly, there was no significant relation between serum concentrations of PZA and drug compliance. Conclusion: TDM is described as an investigational tool to explore means of improving therapeutic outcomes and reducing toxicity of the current MDRTB medications. Further investigations are still needed.

Keywords

• Pyrazinamide (PZA); cycloserine multidrug resistant tuberculosis; therapeutic drug monitoring (TDM) (Siriraj Med J 2017;69: 85-93)