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Free Content Rifampicin serum levels in childhood tuberculosis

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BACKGROUND: Rifampicin (RMP) is an essential drug in paediatric anti-tuberculosis treatment. The current World Health Organization (WHO) guidelines recommend an oral dosage of 10 (8–12) mg per kg body weight.

OBJECTIVE: To present a study investigating RMP serum levels in children after oral medication of RMP alone and after combination treatment with ethambutol (EMB).

DESIGN: RMP serum levels in children of different age groups were determined after a single oral administration of 10 mg/kg RMP alone as well as after combination with 35 mg/kg EMB.

RESULTS: RMP serum levels were lower than those expected in adults receiving a similar oral dose. RMP serum levels in combination treatment were even lower than in monotherapy.

CONCLUSION: Currently recommended RMP dosages in childhood tuberculosis lead to serum levels lower than those recommended for adults, probably due to different pharmacokinetics and pharmacodynamics in children. In children, it appears to be more valid to calculate RMP dosage on the basis of body surface area rather than body weight, leading to higher dosages especially in younger children.
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Keywords: childhood tuberculosis; pharmacokinetics; rifampicin; serum levels

Document Type: Regular Paper

Affiliations: 1: Department of Paediatric Pneumology and Immunology, Helios Klinikum Emil von Behring, Chest Hospital Heckeshorn, Berlin, Germany 2: Department of Paediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany 3: Department of Paediatric Pneumology and Immunology, Helios Klinikum Emil von Behring, Chest Hospital Heckeshorn, Berlin, Germany; and Department of Paediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany

Publication date: 2009-09-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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