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[Isoniazid therapy and monitoring plasma levels]

G Lamedica, G Penco, M M Spandonari

    La Pediatria Medica E Chirurgica : Medical and Surgical Pediatrics
    |January 1, 1984
    PubMed

    Insights

    Pediatric tuberculosis patients on isoniazid and rifampin showed similar pharmacokinetics to adults. Further research is needed to optimize isoniazid dosing for children, especially those with tuberculous meningitis.

    Area of Science:

    • Pharmacology
    • Pediatrics
    • Infectious Diseases

    Context:

    • Tuberculosis (TB) treatment in children requires careful dosing of antitubercular drugs.
    • Isoniazid (INH) is a key component in multi-drug TB regimens.
    • Understanding drug pharmacokinetics in pediatric populations is crucial for effective treatment.

    Purpose:

    • To evaluate the pharmacokinetics of isoniazid in children undergoing chronic therapy for tuberculosis.
    • To compare pediatric isoniazid pharmacokinetics with adult data.
    • To inform optimal isoniazid dosing strategies in pediatric TB patients.

    Summary:

    • Fifteen children (1-13 years) receiving chronic isoniazid (INH) and rifampin therapy were monitored.
    • Pediatric pharmacokinetic parameters for INH were comparable to those reported in adults.
    • Lower INH concentrations were observed in cerebrospinal fluid compared to plasma in patients with external ventricular drainage.

    Impact:

    • Findings suggest that standard adult dosing guidelines for INH may be applicable to children.
    • Highlights the need for dose-optimization studies, comparing 5 mg/kg and 10 mg/kg INH doses.
    • Emphasizes the importance of considering reduced INH penetration into the central nervous system for treating tuberculous meningitis.

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