Low plasma concentrations of rifampicin in tuberculosis patients in Indonesia
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.
Document Type: Regular Paper
Affiliations: 1: Department of Internal Medicine, University Medical Centre Nijmegen, The Netherlands 2: Department of Internal Medicine, Padjadjaran University, Bandung, Indonesia 3: Department of Pulmonary Medicine, University Medical Centre Nijmegen, The Netherlands 4: Perkumpulan Pemberantasan Tuberkulosa Indonesia (PPTI), Jl Baladewa, Jakarta, Indonesia 5: Department of Clinical Pharmacology, University Medical Centre Nijmegen, The Netherlands 6: Working Group on Infectious Diseases, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
Publication date: June 1, 2002
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