SourceInternational Journal of Tuberculosis and Lung Disease, 6, 6, (2002), pp. 497-502
Article / Letter to editor
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International Journal of Tuberculosis and Lung Disease
SubjectThe role of cytokines in the pathophysiology of febrile illnesses and in host defense against infections; Rational Use of Drugs and Pharmaco-epidemiology; Control mechanisms in asthma and chronic obstructive pulmonary disease.; De rol van cytokinen in de pathofysiologie van koortsende ziekten en in de afweer tegen infecties; Rationeel Geneesmiddelengebruik en Farmaco-epidemiologie; Regulatie mechanismen bij astma en chronisch obstructieve longaandoeningen
SETTING: Although rifampicin is a key drug in tuberculosis treatment, little is known about its quality and bioavailability in countries endemic for tuberculosis. High drug levels may lead to increased toxicity, while low drug levels may predispose to treatment failure and relapse. OBJECTIVE: To investigate possible variations in the bioavailability of plasma rifampicin in tuberculosis patients in Indonesia. DESIGN: Plasma concentrations of rifampicin and the rifampicin content of drug formulations in use were measured among 62 non-selected tuberculosis patients in Jakarta, Indonesia. RESULTS: Plasma concentrations of rifampin were generally low: 70% of patients had 2-hour plasma concentrations (Cmax) below 4 mg/L. No toxic plasma concentrations of rifampicin (>20 mg/L) were found. The strongest predictive factor for the magnitude of rifampicin concentrations was the drug manufacturer. The rifampicin content of the different drug preparations used was normal (90.5-103.6% of the reference standard). No association was found between low plasma rifampicin concentrations and delayed sputum conversion or treatment failure. CONCLUSION: The unexpectedly low plasma concentrations of rifampicin in this setting are most likely due to reduced bioavailability of local drug preparations, as the rifampicin content of the drug preparations was found to be normal. The clinical significance of these findings remains to be determined.
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- Faculty of Medical Sciences 
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