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Isoniazid and acetylisoniazid kinetics in serum and urine in pulmonary primary complex with intermittent regimen

V Seth1, S D Seth, A Beotra

  • 1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.

Indian Pediatrics
|March 1, 1994
PubMed

Insights

This study measured isoniazid and acetylisoniazid levels in children with pulmonary primary complex on an intermittent regimen. Results show peak drug concentrations and half-life, informing pediatric tuberculosis treatment.

Area of Science:

  • Pharmacokinetics and Drug Metabolism
  • Pediatric Infectious Diseases
  • Tuberculosis Treatment

Background:

  • Pediatric primary tuberculosis requires effective and safe treatment regimens.
  • Understanding drug concentrations is crucial for optimizing intermittent therapy in children.
  • Isoniazid (INH) and acetylisoniazid (AcINH) are key metabolites in tuberculosis treatment.

Purpose of the Study:

  • To investigate serum and urine concentrations of isoniazid (INH) and acetylisoniazid (AcINH) in pediatric patients with pulmonary primary complex (PPC).
  • To evaluate drug pharmacokinetics during an intermittent treatment regimen (2HR, 4H2R2) in children.
  • To determine peak concentrations, time to peak, and half-life of INH and AcINH.

Main Methods:

  • Twenty pediatric patients (1-13 years) with PPC received an intermittent regimen of INH and rifampicin.
  • Serum and urine samples were collected at specific intervals during the biweekly phase of treatment.
  • High-performance liquid chromatography (HPLC) was used to quantify INH and AcINH concentrations.

Main Results:

  • Peak serum concentrations (Cmax) for INH and AcINH were 2.6 ± 1.8 and 5.5 ± 2.6 µg/ml, respectively.
  • Peak urine concentrations for INH and AcINH were 5.7 ± 4.8 and 21.5 ± 12.1 mg, respectively.
  • The half-life (T1/2) of INH was 4.5 hours, with a pre-dose concentration of 0.47 ± 0.3 µg/ml in the biweekly phase.

Conclusions:

  • The study provides pharmacokinetic data for isoniazid and acetylisoniazid in children with PPC on intermittent therapy.
  • These findings can aid in refining dosing strategies for pediatric tuberculosis treatment.
  • Understanding drug levels is essential for ensuring treatment efficacy and safety in young patients.

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