In the 2016 update of the World Health Organization treatment guideline for drug-resistant tuberculosis (TB), a shorter multidrug-resistant TB regimen was proposed because of its higher treatment outcomes [1]. However, therapeutic drug monitoring (TDM) is an excellent method to improve clinical outcomes as well and its practice is on the rise [2]. A well-known side-effect of group B injectable anti-TB drugs (e.g. amikacin) is ototoxicity [3]. TDM could also be a solution to minimise side-effects by lowering the drug exposure [4]. In the study by van Altena et al. [5], TDM was practised using the ratio of peak concentration (Cmax) to minimal inhibitory concentration (MIC) and this resulted in a reduction in patients with hearing loss. Saliva is considered as an alternative matrix for TDM because it is easy, noninvasive and more patient friendly to sample [6]. Studies found a limited penetration of gentamycin and tobramycin into saliva [7], while detectable levels of amikacin in saliva of neonates were reported [8]. Given the low penetration of aminoglycosides into saliva and interest in Cmax for TDM of amikacin, our objective was to study whether the salivary Cmax of amikacin is measurable and useful in salivary TDM. Salivary CmaxTDM of amikacin was not feasible in TB treatment due to the very low penetration into saliva http://ow.ly/d6v230h0bWG

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阿米卡星无法渗透到结核病患者的唾液中

世界卫生组织 2016 年更新的耐药结核病 (TB) 治疗指南中，提出了更短的耐多药结核病治疗方案，因为它具有更高的治疗效果[1]。然而，治疗药物监测 (TDM) 也是改善临床结果的极好方法，其实践正在增加 [2]。B 组可注射抗结核药物（如阿米卡星）的一个众所周知的副作用是耳毒性 [3]。TDM 也可以作为一种解决方案，通过降低药物暴露来最大限度地减少副作用 [4]。在 van Altena 等人的研究中。[5]，TDM 是使用峰值浓度 (Cmax) 与最小抑制浓度 (MIC) 的比率来实践的，这导致听力损失患者的减少。唾液被认为是 TDM 的替代矩阵，因为它很容易，无创且对患者更友好 [6]。研究发现庆大霉素和妥布霉素对唾液的渗透有限[7]，而据报道新生儿唾液中可检测到的阿米卡星水平[8]。鉴于氨基糖苷类在唾液中的渗透率低，并且对阿米卡星 TDM 的 Cmax 感兴趣，我们的目标是研究阿米卡星的唾液 Cmax 是否可测量并用于唾液 TDM。由于对唾液的渗透性非常低，阿米卡星的唾液 CmaxTDM 在结核病治疗中不可行 http://ow.ly/d6v230h0bWG 我们的目标是研究阿米卡星的唾液 Cmax 在唾液 TDM 中是否可测量和有用。由于对唾液的渗透性非常低，阿米卡星的唾液 CmaxTDM 在结核病治疗中不可行 http://ow.ly/d6v230h0bWG 我们的目标是研究阿米卡星的唾液 Cmax 在唾液 TDM 中是否可测量和有用。由于对唾液的渗透性非常低，阿米卡星的唾液 CmaxTDM 在结核病治疗中不可行 http://ow.ly/d6v230h0bWG