Pharmacodynamic indices for rifampicin, clarithromycin, amikacin, and moxifloxacin are seldom met. ![]() C max/MIC or AUC/MIC ratios associated with bactericidal activity were seldom met 57% of patients achieved target ratios for ethambutol, versus 42% for clarithromycin, 19% for amikacin, 18% for rifampicin, and 11% for moxifloxacin.Ĭonclusions: Currently recommended regimens for MAC lung disease yield important pharmacologic interactions and low concentrations of key drugs including macrolides. Concurrent administration of rifampicin led to 68%, 23%, and 10% decreases in C max of clarithromycin, azithromycin, and moxifloxacin. Peak serum concentrations (C max) below target range were frequent for ethambutol (48% of patients) clarithromycin (56%) and azithromycin (35%). Measurements and Main Results: We included 531 pharmacokinetic analyses, performed for 481 patients (84% females mean age, 63 yr mean body mass index, 21.6). Minimum inhibitory concentrations (MIC) of their MAC isolates were retrieved for pharmacodynamic calculations. Methods: We retrospectively collected pharmacokinetic data of all patients treated for MAC lung disease in the Adult Care Unit at National Jewish Health, Denver, Colorado, in the January 2006 to January 2010 period we retrospectively calculated areas under the time-concentration curve (AUC). Objectives: To study pharmacokinetics, pharmacodynamics, and drug interactions of multidrug treatment regimens in a large cohort of patients with MAC lung disease. This results, in part, from incomplete understanding of the pharmacokinetics and pharmacodynamics of the drugs. Rationale: Currently recommended multidrug treatment regimens for Mycobacterium avium complex (MAC) lung disease yield limited cure rates.
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