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Volume 27, Number 1—January 2021
Research Letter

Novel 6-Month Treatment for Drug-Resistant Tuberculosis, United States

Connie A. HaleyComments to Author , Patricia Macias, Supriya Jasuja, Betsy A. Jones, Marie-Claire Rowlinson, Roshni Jaimon, Pennelyn Onderko, Elaine Darnall, Maria E. Gomez, Charles Peloquin, David Ashkin, and Neela D. Goswami
Author affiliations: University of Florida, Gainesville, Florida, USA (C.A. Haley, M.E. Gomez, D. Ashkin); Cook County Department of Public Health, Chicago, Illinois, USA (P. Macias, S. Jasuja, R. Jaimon, P. Onderko); Florida Department of Health, Jacksonville, Florida, USA (B.A. Jones, M.-C. Rowlinson, D. Ashkin); Illinois Department of Public Health, Springfield, Illinois, USA (E. Darnall); University of Florida College of Pharmacy, Gainesville (C. Peloquin); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (N.D. Goswami)

Main Article

Table 1

Molecular susceptibility sequencing results and therapeutic drug monitoring data from treatment of XDR TB, Florida, USA*

Drug (dose) Sequencing result Date drug level drawn Trough, µg/mL 2h postdose level, µg/mL 6h postdose level, µg/mL Typical peak serum concentration, µg/mL
Bedaquiline (200 mg MWF) No atpE (ORF) mutation detected; no Rv0678/mmpR (ORF) mutation detected 2019 Nov 13 0.51 (42.25 h postdose) 1.40 1.42 1.2–1.8
(5–6 h postdose, maintenance phase)
N-monodesmethyl bedaquiline (metabolite) NT 2019 Nov 13 0.22 (42.25 h postdose) 0.24 0.27 NT
Pretomanid (200 mg/d) NT 2019 Nov 13 2.07 (18.25 h postdose) 3.43 2.98 2.3–4.3
(5–6 h postdose, at steady state)
Linezolid (600 mg/d) No rplC (ORF aa 84–217) mutation detected; no rrl (nt 2191–2929) mutation detected 2019 Nov 13 7.62 (18.25 h postdose) 24.15 17.88 12–26
Linezolid (600 mg MWF) NT 2020 Mar 12 <2.00† 19.04 13.6 12–26

*MWF, Monday/Wednesday/Friday; NT, not tested; ORF, open reading frame; XDR, extensively drug-resistant tuberculosis.
†Trough sample was not collected; based on the apparent elimination half-life, the linezolid concentration at 48 h was calculated to be <2 µg/mL, a value associated with minimal toxicity.

Main Article

Page created: October 28, 2020
Page updated: December 21, 2020
Page reviewed: December 21, 2020
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