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- Title
Rifampicin Can Be Given as Flat-Dosing Instead of Weight-Band Dosing.
- Authors
Susanto, Budi O; Svensson, Robin J; Svensson, Elin M; Aarnoutse, Rob; Boeree, Martin J; Simonsson, Ulrika S H
- Abstract
Background The weight-band dosing in tuberculosis treatment regimen has been implemented in clinical practice for decades. Patients will receive different number of fixed dose combination tablets according to their weight-band. However, some analysis has shown that weight was not the best covariate to explain variability of rifampicin exposure. Furthermore, the rationale for using weight-band dosing instead of flat-dosing becomes questionable. Therefore, this study aimed to compare the average and the variability of rifampicin exposure after weight-band dosing and flat-dosing. Methods Rifampicin exposure were simulated using previously published population pharmacokinetics model at dose 10–40 mg/kg for weight-band dosing and dose 600–2400 mg for flat-dosing. The median area under the curve (AUC0–24 h) after day 7 and 14 were compared as well as the variability of each dose group between weight-band and flat-dosing. Results The difference of median AUC0–24 h of all dose groups between flat-dosing and weight-band dosing were considered low (< 20%) except for the lowest dose. At the dose of 10 mg/kg (600 mg for flat-dosing), flat-dosing resulted in higher median AUC0–24h compared to the weight-band dosing. A marginal decrease in between-patient variability was predicted for weight-band dosing compared to flat-dosing. Conclusions Weight-band dosing yields a small and non-clinically relevant decrease in variability of AUC0–24h.
- Subjects
DRUG therapy for tuberculosis; BODY weight; COMBINATION drug therapy; COMPARATIVE studies; DOSE-effect relationship in pharmacology; RIFAMPIN; DESCRIPTIVE statistics; DRUG administration; DRUG dosage
- Publication
Clinical Infectious Diseases, 2020, Vol 71, Issue 12, p3055
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciz1202