Effects of Moxifloxacin PK-PD and drug interactions on its use in the Treatment of Tuberculosis(TB)
|
|
- Nelson Jackson
- 5 years ago
- Views:
Transcription
1 Effects of Moxifloxacin PK-PD and drug interactions on its use in the Treatment of Tuberculosis(TB) Session: Fanning the Flames of HIV and TB Cointeraction SA AIDS Conference-Durban ICC June 2017 Anushka Naidoo CAPRISA is the UNAIDS Collaborating Centre for HIV Research and Policy CAPRISA hosts a DST- NRF Centre of Excellence in HIV Prevention CAPRISA hosts a MRC HIV-TB Pathogenesis and Treatment Research Unit
2 TB incidence rates/ HIV prevalence in new and relapse TB cases in 2015 >300 cases per population >50% HIV prevalence in new TB cases
3 Globally Background ~ 10.4 million cases of tuberculosis in 2015 ~ 1.1 million of whom were co-infected with HIV The African Region had 26% of the world s tuberculosis cases in South Africa is one of the highest tuberculosis-hiv burden countries in the world Early detection, diagnosis and effective treatment of tuberculosis is critical
4 Role of Moxifloxacin in treatment of TB Moxifloxacin~8-methoxy fluoroquinolone with potent activity against MTB Recommended by the World Health Organisation for treatment of MDR-TB May be used in drug susceptible TB when toxicity develops to first line drugs or for INH mono-resistance Investigated in several clinical trials to determine ability to shorten the duration of TB treatment for both drugsusceptible and MDR-TB Current evidence does not support the use of moxifloxacin in treatment shortening drug regimens in drug susceptible tuberculosis
5 STREAM MDR TB TRIAL- Stage 1-Moxifloxacin, clofazimine, ethambutol and pyrazinamide, + kanamycin, isoniazid and prothionamide
6 Conclusions The two moxifloxacin-containing regimens produced a more rapid initial decline in bacterial load, as compared with the control group. However, non-inferiority for these regimens was not shown, which indicates that shortening treatment to 4 months was not effective in this setting. Gillespie et al 2014 CONCLUSIONS The 6-month regimen that included weekly administration of high-dose rifapentine and moxifloxacin was as effective as the control regimen. The 4-month regimen was not non-inferior to the control regimen. Jindani et al 2014
7 Reasons for failure? Mouse model of TB and MTB cultured in the laboratory does not fully represent the human model of infection? Eight week sputum culture conversion endpoint used in earlier studies is not as predictive of relapse as was thought previously? Moxifloxacin distribution in caseum? Reinfection vs Relapse? Is the 400mg Dose of Moxifloxacin Adequate in all patients? Other?
8 ? Is a 400mg daily dose of Moxifloxacin adequate in all patients Rifampicin may decrease Moxifloxacin AUC by 30% Including drug exposure as a covariate in ReMOX analysis may have contributed to explaining unfavourable outcome Limited data show 800mg dose may be safe Alffenaar et al NEJM 2015 Feb
9 Rifampicin/Moxifloxacin interaction Moxifloxacin is metabolized by UDPglucuronosyltransferase (UGT) and sulphotransferase and is a substrate of the drug transporter P-glycoprotein Several studies found that rifampicin co-administration decreased moxifloxacin plasma concentrations by up to 31%, due to rifampicin induction of UGT and P- glycoprotein.
10 Rifampicin Moxifloxacin by 27-30% in healthy individuals in India and USA and TB patients in Indonesia,
11 Knowledge gaps Lack of data on the effect of rifampicin co-administration on moxifloxacin pharmacokinetics in African patients with tuberculosis. Impact of HIV co-infection and ART co-treatment on moxifloxacin pharmacokinetics in high HIV burden settings. Clinically validated targets of moxifloxacin efficacy for treatment of tuberculosis
12 Improving Retreatment Success- IMPRESS IMPRESS RCT designed to determine if a moxifloxacin-containing regimen, substituting moxifloxacin for ethambutol, of 24 weeks duration is superior to a standard control regimen of 24 weeks duration in improving recurrent tuberculosis treatment outcomes. We conducted a pharmacokinetic sub-study within the IMPRESS trial conducted at CAPRISA
13 Objective We compared the pharmacokinetics of moxifloxacin in the presence of rifampicin co-treatment or when dosed alone in African patients, with drug susceptible, recurrent tuberculosis, the majority of whom were HIV co-infected and on efavirenz-based antiretroviral therapy (ART)
14 Naidoo et al 2017
15 Results Fifty-eight patients studied; 41(70.7%) were male, 42(72.4%) HIV co-infected and 40(95%) on efavirenz-based ART. Oral clearance (CL/F) with rifampicin-based TB treatment was 24.3 L/h for a typical patient and AUC of 16.5 h mg/l. In keeping with previous studies 29% increase in moxifloxacin intrinsic clearance was observed during rifampicin based tuberculosis treatment. Unexpectedly, in HIV co-infected patients taking efavirenz-based ART, CL/F of moxifloxacin was increased by 42.4% resulting in a 30% reduction in moxifloxacin AUC both during TB treatment with rifampicin or after
16 Scenario Steady-State Moxifloxacin on RIF-based TB treatment NO EFV Steady-State Moxifloxacin on RIF-based TB treatment + EFV Intrinsic CL (L/h) Hepatic Extraction (E H ) (%) % Pre-hepatic bioavailabilit y (F pre-h ) (%) 100% - Reference Oral CL (CL/F) (L/h) Change in CL/F (%) AUC (h mg/l) b 24.3 REFERENCE % 100% % 11.6 Single Dose Moxifloxacin without RIF-based TB treatment % 77% % 17.9 NO EFV a Single Dose Moxifloxacin without RIF-based TB treatment % 77% % EFV a
17 Clinical relevance? Moxifloxacin exhibits dose dependent activity- factors affecting in drug exposure are likely to impact clinical efficacy AUC:MIC ratio shown to be a predictor of moxifloxacin clinical efficacy Although the moxifloxacin/efavirenz interaction needs validation in other studies, it is concerning, given the high HIV-TB co-infection rates in many TB endemic settings where the ART backbone remains efavirenz. The effects of efavirenz may have direct implications for studies evaluating novel drug regimens containing moxifloxacin and for current national and international guidelines that advocate moxifloxacin use in treatment regimens for both drug-susceptible and drug resistant tuberculosis.
18 Future studies Clinically validated targets for treatment efficacy need to be defined for moxifloxacin and other TB drugs New clinical trials in TB treatment should include PK-PD studies to determine effect of drug exposure (such as AUC:MIC ratio) on treatment outcomes New technologies such as use of dry blood spots to measure drug concentrations and sensititre plates for MIC testing may make these studies more feasible in RLS
19 Acknowledgements The IMPRESS trial was funded by the European & Developing Countries Clinical Trials Partnership (EDCTP) (TA ) South African Medical Research Council CAPRISA HIV-TB Pathogenesis and Treatment Research Unit South African Medical Research Council Self-Initiated Research Grant CAPRISA was established as part of the Comprehensive International Program of Research on AIDS (CIPRA) of the National Institutes of Health (NIH) (grant# AI51794) Co-investigators/Collaborators: Nesri Padayatachi, Paolo Denti, Maxwell Chirhewa, Helen McIlleron, Kogieleum Naidoo, Sabiha Essack, Nonhlanhla Yende-Zuma, Eddy K. Phongi, John Adamson, Katya Govender The IMPRESS Study Participants CAPRISA is the UNAIDS Collaborating Centre for HIV Research and Policy CAPRISA hosts a DST- NRF Centre of Excellence in HIV Prevention CAPRISA hosts a MRC HIV-TB Pathogenesis and Treatment Research Unit CAPRISA Partner Institutions:
20 (a) MALDI mass spectrometry imaging of small molecules in TB-infected lung tissue. The relative ion abundance of specific analytes in regions of interest delineated on the basis of histology staining can be measured to provide semiquantitative data. (b) Ion maps of PZA and MXF in representative (selected from more than 200 lesions) lung lesions sampled throughout the dosing interval; signal intensity is fixed for each drug. Hematoxylin and eosin (H&E) staining of adjacent sections is also shown (bottom). Outlines highlight the necrotic center of each lesion. Scale bars, 5 mm.(c) Left, diffusion of MXF in caseum as a function of caseum cellularity. **P < 0.05, two-tailed unpaired t-test. Error bars, mean ± s.d. (n = 3). Right, a typical H&E example representative of each cellularity score. Prideaux et al 2015
Clinical Management : DR-TB
Clinical Management : DR-TB Charoen Chuchottaworn MD., Senior Medical Advisor, Central Chest Institute of Thailand, Department of Medical Services, MoPH. Tuberculosis Classification Drug susceptible TB
More informationDrug-resistant TB therapy: the future is now
Drug-resistant TB therapy: the future is now Gary Maartens Thanks to Francesca Conradie for sharing slides Division of Clinical Pharmacology UNIVERSITY OF CAPE TOWN IYUNIVESITHI YASEKAPA UNIVERSITEIT VAN
More informationTB New Drugs, Shorter Courses
TB New Drugs, Shorter Courses Brian Chong John Hunter Hospital, Newcastle NSW Talk supervisor: Chris Coulter Disclosures Unfortunately none 1 Current Situation In 2013, Australia had: 1,263 notified TB
More informationNew drugs and regimens for treatment of drug-sensitive TB (DS-TB) Patrick
New drugs and regimens for treatment of drug-sensitive TB (DS-TB) Patrick Phillips Patrick.Phillips@ucsf.edu @PPJPhillips Outline Overview of regimen development strategies 1-3 year horizon: Ongoing phase
More informationPOPULATION PHARMACOKINETICS AND PHARMACODYNAMICS OF OFLOXACIN IN SOUTH AFRICAN PATIENTS WITH DRUG- RESISTANT TUBERCULOSIS
POPULATION PHARMACOKINETICS AND PHARMACODYNAMICS OF OFLOXACIN IN SOUTH AFRICAN PATIENTS WITH DRUG- RESISTANT TUBERCULOSIS Emmanuel Chigutsa 1, Sandra Meredith 1, Lubbe Wiesner 1, Nesri Padayatchi 2, Joe
More informationTHE NEW DR-TB NATIONAL POLICY AND STATE OF IMPLEMENTATION
1 THE NEW DR-TB NATIONAL POLICY AND STATE OF IMPLEMENTATION Dr. Norbert Ndjeka MD, DHSM (Wits), MMed(Fam Med) (MED), Dip HIV Man (SA) Director Drug-Resistant TB, TB and HIV National Department of Health
More informationMDR-TB drugs per WHO guidelines
New antituberculous agents for drug-resistant resistant TB Symposium Belgian Society of Infectiology and Clinical Microbiology November 9 Jens Van Roey, MD - Tibotec Definitions MDR-TB multidrug resistance
More informationTreatment for NTM: when how.and what next? Pr Claire Andréjak Respiratory and ICU Department University hospital, Amiens, France
Treatment for NTM: when how.and what next? Pr Claire Andréjak Respiratory and ICU Department University hospital, Amiens, France First step = To diagnose NTM disease One NTM positive sample NTM disease
More informationChallenges to treat MDR TB
Challenges to treat MDR TB Manfred Danilovits Tartu University Hospital, Estonian NTP Program 2nd European Advanced Course in Clinical Tuberculosis 22-24 September 2014, Amsterdam MDR-TB control; WHO Europe,
More informationManagement of MDR and XDR TB Prof. Martin Boeree
Management of MDR and XDR TB 1, MD, PhD Associate Professor Consultant Respiratory Medicine Department of Lung Diseases Radboud University Nijmegen Medical Centre TB Referral Hospital Dekkerswald Nijmegen,
More informationMDR/XDR TB. Barbara Seaworth, MD, FIDSA, FACP October 27, TB Intensive October 24 27, 2017 San Antonio, TX
MDR/XDR TB Barbara Seaworth, MD, FIDSA, FACP October 27, 2017 TB Intensive October 24 27, 2017 San Antonio, TX EXCELLENCE EXPERTISE INNOVATION Barbara Seaworth, MD, FIDSA, FACP, has the following disclosures
More informationMultidrug-resistant Tuberculosis. Charles L. Daley, MD National Jewish Health Chair, Global GLC, WHO and Stop TB Partnership
Multidrug-resistant Tuberculosis Charles L. Daley, MD National Jewish Health Chair, Global GLC, WHO and Stop TB Partnership Disclosures World Health Organization Chair, Global GLC Otsuka Chair, Data Monitoring
More informationStrategies for Successful Treatment of Drug Resistant Tuberculosis in the U.S.
Strategies for Successful Treatment of Drug Resistant Tuberculosis in the U.S. Barbara J. Seaworth, M.D. Professor of Medicine University of Texas Health Science Center, Tyler Medical Director, Heartland
More informationDrug resistant TB: The role of the laboratory
Drug resistant TB: The role of the laboratory 26 Oct 2012 Andrew Whitelaw NHSLS / UCT TB lab functions: Outline Resistance testing Genotypic Phenotypic Which tests are done when, and why Reporting of
More informationTB Intensive Houston, Texas. Multi-Drug Resistant (MDR) TB Barbara Seaworth, MD
TB Intensive Houston, Texas November 10-12, 12 2009 Multi-Drug Resistant (MDR) TB Barbara Seaworth, MD November 12, 2009 Multi-Drug Resistant (MDR) TB Updates November 12, 2009 Barbara J. Seaworth Professor
More informationTB Intensive San Antonio, Texas
TB Intensive San Antonio, Texas April 6-8, 2011 Drug Resistant TB Barbara Seaworth, MD Thursday April 7, 2011 Barbara Seaworth, MD has the following disclosures to make: Has received research funding from
More informationMulti-Drug and Extensively Drug Resistant Tuberculosis
Multi-Drug and Extensively Drug Resistant Tuberculosis Gwen A. Huitt, M.D., M.S. Professor, Department of Medicine Director, Adult Infectious Disease Care Unit National Jewish Health Disclosures None Tuberculosis
More informationQuality of 2 nd line medicines for tuberculosis. Ms Lisa Hedman World Health Organization Department of Essential Medicines and Health Products
Quality of 2 nd line medicines for tuberculosis Ms Lisa Hedman World Health Organization Department of Essential Medicines and Health Products Case studies in medicines for tuberculosis Outline: Statistics
More informationSummary of outcomes from WHO Expert Group Meeting on Drug Susceptibility Testing - PRELIMINARY -
Summary of outcomes from WHO Expert Group Meeting on Drug Susceptibility Testing PRELIMINARY 4 th Annual GLI meeting 17 April 2012 Fuad Mirzayev Laboratories, Diagnostics and Drug Resistance unit, Stop
More informationTreatment of MDR/XDR-TB. Short course chemotherapy for MDR-TB: practical issues. CHIANG Chen-Yuan MD, MPH, DrPhilos
Treatment of MDR/XDR-TB Short course chemotherapy for MDR-TB: practical issues CHIANG Chen-Yuan MD, MPH, DrPhilos Treatment strategies for MDR-TB Standardized treatment: drug resistance survey data from
More informationTreatment of Multidrug-resistant Tuberculosis (MDR-TB)
Treatment of Multidrug-resistant Tuberculosis (MDR-TB) 2006 2008 2011 2013 2014 2016 2019 Charles L. Daley, MD National Jewish Health University of Colorado Disclosures Research grant Insmed: Phase II
More informationETX2514SUL (sulbactam/etx2514) for the treatment of Acinetobacter baumannii infections
ETX2514SUL (sulbactam/etx2514) for the treatment of Acinetobacter baumannii infections Robin Isaacs Chief Medical Officer, Entasis Therapeutics Dr. Isaacs is a full-time employee of Entasis Therapeutics.
More informationMultidrug resistant tuberculosis. Where next? Professor Peter D O Davies (Liverpool)
Multidrug resistant tuberculosis. Where next? Professor Peter D O Davies (Liverpool) DOTS + and LTBI New drugs for TB and the challenge of resistance talk plan 1. Epidemiology 2. Treatment 3. The MDRTB
More informationUniversity of Groningen. Tuberculosis and its sequelae Akkerman, Onno
University of Groningen Tuberculosis and its sequelae Akkerman, Onno IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document
More informationESCMID Online Lecture Library. by author
Treatment of community-acquired meningitis including difficult to treat organisms like penicillinresistant pneumococci and guidelines (ID perspective) Stefan Zimmerli, MD Institute for Infectious Diseases
More informationINCIDENCE OF BACTERIAL COLONISATION IN HOSPITALISED PATIENTS WITH DRUG-RESISTANT TUBERCULOSIS
INCIDENCE OF BACTERIAL COLONISATION IN HOSPITALISED PATIENTS WITH DRUG-RESISTANT TUBERCULOSIS 1 Research Associate, Drug Utilisation Research Unit, Nelson Mandela University 2 Human Sciences Research Council,
More informationTB Intensive San Antonio, Texas
TB Intensive San Antonio, Texas May 6 9, 2014 MDR/XDR TB Barbara Seaworth, MD May 9, 2014 Barbara Seaworth, MD has the following disclosures to make: No conflict of interests No relevant financial relationships
More informationTreatment of Drug Resistant TB
Treatment of Drug Resistant TB Diana M. Nilsen RN, MD Bureau of TB Control New York City Department of Health & Mental Hygiene Objectives Definition of other drug resistant (ODR), multiple drug resistant
More informationTB Intensive Houston, Texas October 15-17, 2013
TB Intensive Houston, Texas October 15-17, 2013 MDR/XDR TB Barbara J. Seaworth, MD October 16, 2013 Barbara J. Seaworth, MD has the following disclosures to make: No conflict of interests No relevant financial
More informationCOMMITTEE FOR VETERINARY MEDICINAL PRODUCTS
The European Agency for the Evaluation of Medicinal Products Veterinary Medicines and Inspections EMEA/CVMP/627/01-FINAL COMMITTEE FOR VETERINARY MEDICINAL PRODUCTS GUIDELINE FOR THE DEMONSTRATION OF EFFICACY
More informationMDR-TB is a manmade problem..it is costly, deadly, debilitating, and the biggest threat to our current TB control strategies 2
1 MDR-TB is a manmade problem..it is costly, deadly, debilitating, and the biggest threat to our current TB control strategies 2 1 India has the highest TB burden in the world 3 4 2 5 M. tuberculosis Resistance
More informationMDR treatment. Shanghai, May 2012 Arnaud Trébucq The Union
MDR treatment Shanghai, May 2012 Arnaud Trébucq The Union Why to diagnose MDR-TB? Outcome of SS+ new MDR-TB cases, treated with First Line TB (FLD) drugs Setting Success Died Fail LFFU Transf. Corea 20(56)
More informationXDR TB: The Laboratory s Dilemma vs The Clinician s Dilemma
XD TB: The Laboratory s Dilemma vs The Clinician s Dilemma Barbara J. Seaworth, MD, FIDSA, FACP, Heartland National TB Center, San Antonio, TX Kenneth Jost, Jr., M(ASCP) Laboratory Services Section, Texas
More informationDr Sharanjit Dhoot. Chelsea and Westminster Hospital, London. 18 th Annual Conference of the British HIV Association (BHIVA)
18 th Annual Conference of the British HIV Association (BHIVA) Dr Sharanjit Dhoot Chelsea and Westminster Hospital, London 18-20 April 2012, The International Convention Centre, Birmingham 18 th Annual
More informationPractical. Walk through New Survival Guide
Many faces of TB: Drug resistant it ttbs Survival lgid Guide v3 P B L Ch G Sh t L T P. Barry, L. Chen, G. Schecter, L. True Curry International TB Center/CTCA April 20, 2016 Real case Practical Walk through
More informationETX0282, a Novel Oral Agent Against Multidrug-Resistant Enterobacteriaceae
ETX0282, a Novel Oral Agent Against Multidrug-Resistant Enterobacteriaceae Thomas Durand-Réville 02 June 2017 - ASM Microbe 2017 (Session #113) Disclosures Thomas Durand-Réville: Full-time Employee; Self;
More informationAnimal models and PK/PD. Examples with selected antibiotics
Animal models and PK/PD PD Examples with selected antibiotics Examples of animal models Amoxicillin Amoxicillin-clavulanate Macrolides Quinolones Andes D, Craig WA. AAC 199, :375 Amoxicillin in mouse thigh
More informationThe pharmacological and microbiological basis of PK/PD : why did we need to invent PK/PD in the first place? Paul M. Tulkens
The pharmacological and microbiological basis of PK/PD : why did we need to invent PK/PD in the first place? Paul M. Tulkens Cellular and Molecular Pharmacology Unit Catholic University of Louvain, Brussels,
More informationTB Grand Rounds. MDR-TB: Management of Adverse Drug Reactions. Reynard J. McDonald, M.D. September 18, Patient History
TB Grand Rounds MDR-TB: Management of Adverse Drug Reactions Reynard J. McDonald, M.D. September 18, 2007 Patient History This 30 y/o H/M was born in Ecuador and immigrated to the US in 2001 On 11-22-05
More informationAntimicrobial Stewardship: The South African Perspective
Antimicrobial Stewardship: The South African Perspective Precious Matsoso Director General; National Department of Health; South Africa 13 th November 2015 Why do we need an AMR strategy and implementation
More informationJerome J Schentag, Pharm D
Clinical Pharmacy and Optimization of Antibiotic Usage: How to Use what you have Learned in Pharmacokinetics and Pharmacodynamics of Antibiotics Jerome J Schentag, Pharm D Presented at UCL on Thursday
More informationCritical Appraisal Topic. Antibiotic Duration in Acute Otitis Media in Children. Carissa Schatz, BSN, RN, FNP-s. University of Mary
Running head: ANTIBIOTIC DURATION IN AOM 1 Critical Appraisal Topic Antibiotic Duration in Acute Otitis Media in Children Carissa Schatz, BSN, RN, FNP-s University of Mary 2 Evidence-Based Practice: Critical
More informationMDR TB AND CASE STUDIES
MDR TB AND CASE STUDIES Chris Keh, MD Director, TB Prevention and Control Program, SFDPH HS Assistant Clinical Professor, Infectious Diseases, UCSF Seattle, CITC Clinical Intensive June 15, 2018 Slide
More informationLefamulin: a novel pleuromutilin antibiotic class George Dimopoulos MD, PhD, FCCP, FCCM, FECMM
: a novel pleuromutilin antibiotic class George Dimopoulos MD, PhD, FCCP, FCCM, FECMM Department of Critical Care, University Hospital ATTIKON National and Kapodistrian University of Athens, Medical School
More informationAntimicrobial Pharmacodynamics
Antimicrobial Pharmacodynamics November 28, 2007 George P. Allen, Pharm.D. Assistant Professor, Pharmacy Practice OSU College of Pharmacy at OHSU Objectives Become familiar with PD parameters what they
More informationDR-TB PATIENT IDENTITY CARD
Ministry of Health Community Development Gender Elderly and Children National Tuberculosis and Leprosy Programme DR-TB 02 DR-TB Treatment Unit: DR-TB PATIENT IDENTITY CARD DR-TB Reg. Number: Date of registration:
More informationTRANSPARENCY COMMITTEE
The legally binding text is the original French version TRANSPARENCY COMMITTEE Opinion 29 October 2014 GRANUPAS, gastro-resistant granules 30 sachets with a calibrated measuring spoon (CIP: 34009 278 801
More informationPierre-Louis Toutain, Ecole Nationale Vétérinaire National veterinary School of Toulouse, France Wuhan 12/10/2015
Antimicrobial susceptibility testing for amoxicillin in pigs: the setting of the PK/PD cutoff value using population kinetic and Monte Carlo Simulation Pierre-Louis Toutain, Ecole Nationale Vétérinaire
More informationCase 1 and Case 2. Case 1 3/23/2016
Case 1 and Deidra D. Parrish, MD, MPH&TM Nashville Metro Public Health Dept TB Symposium March 30, 2016 Case 1 27 yo Indian woman came to the US to join her husband three months prior to clinic visit.
More informationApril 25, 2018 Edited by: Gregory K. Perry, PharmD, BCPS-AQID
VOLUME FOUR; ISSUE 4 April 25, 2018 Edited by: Gregory K. Perry, PharmD, BCPS-AQID InPHARMation Pharmacy and Therapeutics Committee Update April 25 th, 2018 Meeting The Pharmacy and Therapeutics Committee
More informationIntroduction to Pharmacokinetics and Pharmacodynamics
Introduction to Pharmacokinetics and Pharmacodynamics Diane M. Cappelletty, Pharm.D. Assistant Professor of Pharmacy Practice Wayne State University August, 2001 Vocabulary Clearance Renal elimination:
More informationPBPK/PD Modeling and Simulations to Guide Dose Recommendation of Amlodipine with Viekirax or Viekira Pak
PBPK/PD Modeling and Simulations to Guide Dose Recommendation of Amlodipine with Viekirax or Viekira Pak Dwaipayan Mukherjee, Ph.D. Jiuhong Zha, Ph.D. Rajeev Menon, Ph.D. Mohamad Shebley, Ph.D. Clinical
More informationTreatment of Nontuberculous Mycobacterial Infections (NTM)
Treatment of Nontuberculous Mycobacterial Infections (NTM) Charles L. Daley, MD National Jewish Health University of Colorado, Denver Disclosures Investigator Insmed (inhaled liposomal amikacin) Advisory
More informationExploring Novel Approaches to Shared TB Laboratory Services: California-Wisconsin Shared Services Pilot Study
Exploring Novel Approaches to Shared TB Laboratory Services: California-Wisconsin Shared Services Pilot Study Julie Tans-Kersten, MS, BS-MT (ASCP) Tuberculosis Laboratory Program Coordinator Wisconsin
More informationOPTIMIZATION OF PK/PD OF ANTIBIOTICS FOR RESISTANT GRAM-NEGATIVE ORGANISMS
HTIDE CONFERENCE 2018 OPTIMIZATION OF PK/PD OF ANTIBIOTICS FOR RESISTANT GRAM-NEGATIVE ORGANISMS FEDERICO PEA INSTITUTE OF CLINICAL PHARMACOLOGY DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, ITALY SANTA
More informationCreating a global community for clinical drug repurposing and development. Leonard Sacks Center for drug evaluation and research FDA
Creating a global community for clinical drug repurposing and development Leonard Sacks Center for drug evaluation and research FDA Neglected tropical diseases 1) Repurposing and developing new drugs 2)
More informationChapter 51. Clinical Use of Antimicrobial Agents
Chapter 51 Clinical Use of Antimicrobial Agents History of antimicrobial therapy Early 17 th century Cinchona bark was used as an important historical remedy against malaria. 1909 Paul Ehrlich sought a
More informationCDC s Molecular Detection of Drug Resistance (MDDR) Service and Mycobacterium tuberculosis DST Model Performance Evaluation Program (MPEP)
CDC s Molecular Detection of Drug Resistance (MDDR) Service and Mycobacterium tuberculosis DST Model Performance Evaluation Program (MPEP) Beverly Metchock, DrPH, D(ABMM) Mycobacteriology Laboratory Branch/Division
More informationNon-Tuberculous Mycobacterial Pulmonary Disease Diagnosis and Management Jakko van Ingen, MD, PhD
Non-Tuberculous Mycobacterial Pulmonary Disease (NTM-PD) 1 Radbound University Nihmegen Medical Center Milestones in NTM research 1980s: Nodular bronchiectatic lung disease Lady Windermere syndrome 1882-1890
More informationThe South African AMR strategy. 3 rd Annual Regulatory Workshop Gavin Steel Sector wide Procurement National Department of Health; South Africa
The South African AMR strategy 3 rd Annual Regulatory Workshop Gavin Steel Sector wide Procurement National Department of Health; South Africa Background to AMR 2 What is Antimicrobial stewardship and
More informationThe New England Journal of Medicine THE TREATMENT OF MULTIDRUG-RESISTANT TUBERCULOSIS IN TURKEY
THE TREATMENT OF MULTIDRUG-RESISTANT TUBERCULOSIS IN TURKEY KEMAL TAHAOĞLU, M.D., TÜLAY TÖRÜN, M.D., TÜLIN SEVIM, M.D., GÜLIZ ATAÇ, M.D., ALTAN KIR, M.D., LEVENT KARASULU, M.D., IPEK ÖZMEN, M.D., AND NILÜFER
More informationThe role of moxifloxacin in tuberculosis therapy
CLINICAL YEAR IN REVIEW TUBERCULOSIS The role of moxifloxacin in tuberculosis therapy Stephen H. Gillespie Affiliation: School of Medicine, University of St Andrews, St Andrews, UK. Correspondence: Stephen
More informationPropofol vs Dexmedetomidine
Propofol vs Dexmedetomidine A highlight of similarities & differences Lama Nazer, PharmD, BCPS Critical Care Clinical Pharmacy Specialist King Hussein Cancer Center Outline Highlight similarities and differences
More informationMultidrug-resistant Tuberculosis
Multidrug-resistant Tuberculosis Pennan Barry, MD, MPH California MDR TB Consult Service Surveillance and Epidemiology Section Curry International Tuberculosis Center Clinical Intensive September 2016
More informationMultidrug resistant Tuberculosis
Multidrug resistant Tuberculosis Pennan Barry, MD, MPH California MDR TB Consult Service Surveillance and Epidemiology Section Curry International Tuberculosis Center Clinical Intensive October 018 Objectives
More informationContribution of pharmacokinetic and pharmacodynamic parameters of antibiotics in the treatment of resistant bacterial infections
Contribution of pharmacokinetic and pharmacodynamic parameters of antibiotics in the treatment of resistant bacterial infections Francois JEHL Laboratory of Clinical Microbiology University Hospital Strasbourg
More informationSterilizing Activities of Fluoroquinolones against Rifampin-Tolerant Populations of Mycobacterium tuberculosis
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Feb. 2003, p. 653 657 Vol. 47, No. 2 0066-4804/03/$08.00 0 DOI: 10.1128/AAC.47.2.653 657.2003 Copyright 2003, American Society for Microbiology. All Rights Reserved.
More informationDevelopment of Drugs for Eradication of Nasal Carriage of S. aureus to Reduce S. aureus Infections in Vulnerable Surgical Patients
Development of Drugs for Eradication of Nasal Carriage of S. aureus to Reduce S. aureus Infections in Vulnerable Surgical Patients Richard Bax Transcrip Partners Bax - Eradication of carriage - EMA 25-26
More informationDrug resistant TB: Lisa Chen, MD University of California, San Francisco Curry Interna:onal TB Center Sea=le, June 2016
Drug resistant TB: Lisa Chen, MD University of California, San Francisco Curry Interna:onal TB Center Sea=le, June 2016 Drug- Resistant TB: De1initions Mono- resistant: Resistance to a single drug Poly-
More informationTb : Recent recommendation. Dr.Ketan Shah
Tb : Recent recommendation Dr.Ketan Shah Tbc : Clinician If you think It is easy to diagnose : u r not good clinician It is difficult to diagnose :U r not alone doctor to think this 6/22/2015 Ketan Shah
More informationdiscover the nextgeneration of flea & tick protection NEW TASTY CHEW ONE CHEW ONCE A MONTH
discover the nextgeneration of flea & tick protection KILLS FLEAS KILLS TICKS ONE CHEW ONCE A MONTH TASTY CHEW NEW Now there s a new oral treatment that offers effective flea AND tick control on dogs for
More informationAntibiotic treatment in the ICU 1. ICU Fellowship Training Radboudumc
Antibiotic treatment in the ICU 1 ICU Fellowship Training Radboudumc Main issues Delayed identification of microorganisms Impact of critical illness on Pk/Pd High prevalence of antibiotic resistant strains
More informationLinezolid: an effective, safe and cheap drug for patients failing multidrug-resistant tuberculosis treatment in India
Eur Respir J 2012; 39: 956 962 DOI: 10.1183/09031936.00076811 CopyrightßERS 2012 Linezolid: an effective, safe and cheap drug for patients failing multidrug-resistant tuberculosis treatment in India R.
More informationOutline. Antimicrobial resistance. Antimicrobial resistance in gram negative bacilli. % susceptibility 7/11/2010
Multi-Drug Resistant Organisms Is Combination Therapy the Way to Go? Sutthiporn Pattharachayakul, PharmD Prince of Songkhla University, Thailand Outline Prevalence of anti-microbial resistance in Acinetobacter
More informationDrug Resistant Tuberculosis:
Drug Resistant Tuberculosis: Pearls and other Considerations John W. Wilson, MD Associate Professor of Medicine Division of Infectious Diseases Mayo Clinic, Rochester MN Mayo Clinic Center for Tuberculosis
More informationSection 6.2.4: Antituberculosis Medicines Application for moving streptomycin to complementary list
Section 6.2.4: Antituberculosis Medicines Application for moving streptomycin to complementary list Stop TB Department World Health Organization Summary According to the recent guideline published in 2010
More informationAntibacterial Resistance: Research Efforts. Henry F. Chambers, MD Professor of Medicine University of California San Francisco
Antibacterial Resistance: Research Efforts Henry F. Chambers, MD Professor of Medicine University of California San Francisco Resistance Resistance Dose-Response Curve Antibiotic Exposure Anti-Resistance
More informationPK/PD to fight resistance
PK/PD to fight resistance Eradicate Abnormal bacteria Mutations Efflux pumps Mutation-Preventing Concentration Breakpoint values for T > MIC and in practice With the support of Wallonie-Bruxelles-International
More informationAUC/MIC relationships to different endpoints of the antimicrobial effect: multiple-dose in vitro simulations with moxifloxacin and levofloxacin
Journal of Antimicrobial Chemotherapy (2002) 50, 533 539 DOI: 10.1093/jac/dkf177 AUC/MIC relationships to different endpoints of the antimicrobial effect: multiple-dose in vitro simulations with moxifloxacin
More informationTreatment of Slowly Growing NTM Infections
Treatment of Slowly Growing NTM Infections Charles L. Daley, MD National Jewish Health University of Colorado, Denver Disclosures Investigator Insmed (inhaled liposomal amikacin) Advisory Committee Insmed
More informationPeriod of study: 12 Nov 2002 to 08 Apr 2004 (first subject s first visit to last subject s last visit)
Study Synopsis This file is posted on the Bayer HealthCare Clinical Trials Registry and Results website and is provided for patients and healthcare professionals to increase the transparency of Bayer's
More informationSESSION XVI NEW ANTIBIOTICS
SESSION XVI NEW ANTIBIOTICS New Antibiotics to Treat Anaerobic Infections 2 Goldstein, E.J.C.;* Citron, D.M. Antibiotic Pharmacodynamics 3 Stein, G.E.* Targeting Selenium Metabolism in Stickland Fermentors:
More information11/22/2016. Antimicrobial Stewardship Update Disclosures. Outline. No conflicts of interest to disclose
Antimicrobial Stewardship Update 2016 APIC-CI Conference November 17 th, 2016 Jay R. McDonald, MD Chief, ID Section VA St. Louis Health Care System Assistant Professor of medicine Washington University
More informationRisk Factors for Poor Outcomes in Patients with Multi-Drug Resistant Tuberculosis in South Korea
Hanyang Med Rev 2016;36:262-268 https://doi.org/10.7599/hmr.2016.36.4.262 pissn 1738-429X eissn 2234-4446 Original Article Risk Factors for Poor Outcomes in Patients with Multi-Drug Resistant Tuberculosis
More informationIvermectin for malaria transmission control
Ivermectin for malaria transmission control Technical consultation meeting report WHO Headquarters Geneva 16 September 2016 Presentation outline Background Rationale for the technical consultation Objectives
More informationComparative studies on pulse and continuous oral norfloxacin treatment in broilers and turkeys. Géza Sárközy
Comparative studies on pulse and continuous oral norfloxacin treatment in broilers and turkeys Géza Sárközy Department of Pharmacology and Toxicology Faculty of Veterinary Science Szent István University
More informationWHO s first global report on antibiotic resistance reveals serious, worldwide threat to public health
New WHO report provides the most comprehensive picture of antibiotic resistance to date, with data from 114 countries 30 APRIL 2014 GENEVA - A new report by WHO its first to look at antimicrobial resistance,
More informationAntimicrobial Resistance Initiative
Antimicrobial Resistance Initiative Antimicrobial Resistance Initiative Resistance to antimicrobial agents has become a threat to public health all over the world. Microorganisms become resistant to antimicrobial
More informationTreatment Duration for Uncomplicated Community-Acquired Pneumonia: The Evidence in Support of 5 Days
Treatment Duration for Uncomplicated Community-Acquired Pneumonia: The Evidence in Support of 5 Days Executive Summary National consensus guidelines created jointly by the Infectious Diseases Society of
More informationUniversité catholique de Louvain, Louvain Drug Research Institute, Brussels, Belgium. Bayer Santé SAS, Loos, France
Communicating Comprehensive Safety Data Gained from Clinical Trials to the Scientific Community: Opportunities and Difficulties from an Example with Moxifloxacin P.M. Tulkens, 1 P. Arvis, 2 F. Kruesmann,
More informationSuccessful stewardship in hospital settings
Successful stewardship in hospital settings Pr Charles-Edouard Luyt Service de Réanimation Institut de Cardiologie Groupe Hospitalier Pitié-Salpêtrière Université Pierre et Marie Curie, Paris 6 www.reamedpitie.com
More informationMoxifloxacin population pharmacokinetics and model-based comparison of efficacy
AAC Accepts, published online ahead of print on 4 November 2013 Antimicrob. Agents Chemother. doi:10.1128/aac.01478-13 Copyright 2013, American Society for Microbiology. All Rights Reserved. 1 2 Moxifloxacin
More informationCurrent Status of Fluoroquinolone Use for Treatment of Tuberculosis in a Tertiary Care Hospital in Korea
ORIGINAL ARTICLE https://doi.org/10.4046/trd.2017.80.2.143 ISSN: 1738-3536(Print)/2005-6184(Online) Tuberc Respir Dis 2017;80:143-152 Current Status of Fluoroquinolone Use for Treatment of Tuberculosis
More informationAppropriate antimicrobial therapy in HAP: What does this mean?
Appropriate antimicrobial therapy in HAP: What does this mean? Jaehee Lee, M.D. Kyungpook National University Hospital, Korea KNUH since 1907 Presentation outline Empiric antimicrobial choice: right spectrum,
More informationRifampicin Reduces Plasma Concentrations of Moxifloxacin in Patients with Tuberculosis
MAJOR ARTICLE Rifampicin Reduces Plasma Concentrations of Moxifloxacin in Patients with Tuberculosis H. M. J. Nijland, 1,3,a R. Ruslami, 4,a A. Juwono Suroto, 5 D. M. Burger, 1,3 B. Alisjahbana, 6 R. van
More informationBRUCELLOSIS BRUCELLOSIS. CPMP/4048/01, rev. 3 1/7 EMEA 2002
BRUCELLOSIS CPMP/4048/01, rev. 3 1/7 General points on treatment Four species are pathogenic to man: B. melitenis (acquired from goats), B. suis (pigs), B. abortus (cattle) and B. canis (dogs). The bacteria
More informationEfficacy of Colistin in combination with Carbapenem and Tigecycline in patients with pneumonia caused by multidrug-resistant Acinetobacter baumannii
Efficacy of Colistin in combination with Carbapenem and Tigecycline in patients with pneumonia caused by multidrug-resistant Acinetobacter baumannii Enty Tjoa 1, Frans Pangalila 2, Lucky H Moehario 1,
More informationPharmacokinetics and Pharmacodynamics of Antimicrobials in the Critically Ill Patient
Pharmacokinetics and Pharmacodynamics of Antimicrobials in the Critically Ill Patient Rania El-Lababidi, Pharm.D., BCPS (AQ-ID), AAHIVP Manager, Pharmacy Education and Training Cleveland Clinic Abu Dhabi
More informationTuberculosis infection in an Asian elephant at a Japanese Zoo and its first treatment in Japan
Tuberculosis infection in an Asian elephant at a Japanese Zoo and its first treatment in Japan Satoshi Ishikawa, Satomi Suga, Yasuhiko Mukai Fukuyama Zoo, Hiroshima Fukuyama Zoo October 22th, 2017 Tuberculosis
More informationStaph Cases. Case #1
Staph Cases Lisa Winston University of California, San Francisco San Francisco General Hospital Case #1 A 60 y.o. man with well controlled HIV and DM presents to clinic with ten days of redness and swelling
More information