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Intrapulmonary pharmacokinetics of ofloxacin in drug-resistant tuberculosis
N Chierakul1, D Klomsawat, S Chulavatnatol
1Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand. chana2508@hotmail.com
Objective:
To determine the lung epithelial lining fluid (ELF) and serum levels of ofloxacin in drug-resistant tuberculosis patients during treatment.
Design:
Ten drug-resistant tuberculosis patients treated with ofloxacin containing regimens for at least 2 weeks were enrolled in the study. Subjects ingested ofloxacin 10 mg/kg and other anti-tuberculosis agents after overnight fasting.
Results:
Serum and bronchoalveolar lavage fluid were collected at 4 hours after treatment and assayed by high performance liquid chromatography. The mean concentrations of ofloxacin in serum and ELF were 5.889 +/- 1.096 and 16.583 +/- 8.697 mg/L, respectively. The mean ratio of ELF-to-serum ofloxacin concentration was 2.825 +/- 1.275.
Conclusion:
Ofloxacin can penetrate well into the intra-alveolar fluid of patients treated for drug-resistant tuberculosis. The lung ELF concentrations were consistently higher than the minimal inhibitory concentrations of Mycobacterium tuberculosis as determined in vitro.