. 2022 Jun 1;26(6):483-499.

doi: 10.5588/ijtld.22.0188.

Clinical standards for the dosing and management of TB drugs

J W C Alffenaar¹, S L Stocker², L Davies Forsman³, A Garcia-Prats⁴, S K Heysell⁵, R E Aarnoutse⁶, O W Akkerman⁷, A Aleksa⁸, R van Altena⁹, W Arrazola de Oñata¹⁰, P K Bhavani¹¹, N Van't Boveneind-Vrubleuskaya¹², A C C Carvalho¹³, R Centis¹⁴, J M Chakaya¹⁵, D M Cirillo¹⁶, J G Cho¹⁷, L D Ambrosio¹⁸, M P Dalcolmo¹⁹, P Denti²⁰, K Dheda²¹, G J Fox²², A C Hesseling²³, H Y Kim¹, C U Köser²⁴, B J Marais²⁵, I Margineanu²⁶, A G Märtson²⁷, M Munoz Torrico²⁸, H M Nataprawira²⁹, C W M Ong³⁰, R Otto-Knapp³¹, C A Peloquin³², D R Silva³³, R Ruslami³⁴, P Santoso³⁵, R M Savic³⁶, R Singla³⁷, E M Svensson³⁸, A Skrahina³⁹, D van Soolingen⁴⁰, S Srivastava⁴¹, M Tadolini⁴², S Tiberi⁴³, T A Thomas⁵, Z F Udwadia⁴⁴, D H Vu⁴⁵, W Zhang⁴⁶, S G Mpagama⁴⁷, T Schön⁴⁸, G B Migliori¹⁴

Affiliations

¹ Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW, Australia, School of Pharmacy, The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia, Westmead Hospital, Sydney, NSW, Australia.
² School of Pharmacy, The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia, Department of Clinical Pharmacology and Toxicology, St Vincent´s Hospital, Sydney, NSW, Australia, St Vincent´s Clinical Campus, University of NSW, Kensington, NSW, Australia.
³ Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Solna, Sweden, Department of Infectious Diseases Karolinska University Hospital, Solna, Sweden.
⁴ Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa, Department of Pediatrics, University of Wisconsin, Madison, WI.
⁵ Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
⁶ Department of Pharmacy, Radboud Institute for Health Sciences & Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
⁷ University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Groningen, The Netherlands, University of Groningen, University Medical Center Groningen, Tuberculosis Center Beatrixoord, Haren, The Netherlands.
⁸ Educational Institution "Grodno State Medical University", Grodno, Belarus.
⁹ Asian Harm Reduction Network (AHRN) and Medical Action Myanmar (MAM) in Yangon, Myanmar.
¹⁰ Belgian Scientific Institute for Public Health (Belgian Lung and Tuberculosis Association), Brussels, Belgium.
¹¹ Indian Council of Medical Research-National Institute for Research in Tuberculosis-International Center for Excellence in Research, Chennai, India.
¹² Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Department of Public Health TB Control, Metropolitan Public Health Services, The Hague, The Netherlands.
¹³ Laboratório de Inovações em Terapias, Ensino e Bioprodutos (LITEB), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
¹⁴ Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Italy.
¹⁵ Department of Medicine, Therapeutics and Dermatology, Kenyatta University, Nairobi, Kenya, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
¹⁶ Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
¹⁷ Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW, Australia, Westmead Hospital, Sydney, NSW, Australia, Parramatta Chest Clinic, Parramatta, NSW, Australia.
¹⁸ Public Health Consulting Group, Lugano, Switzerland.
¹⁹ Reference Center Hélio Fraga, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil.
²⁰ Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
²¹ Centre for Lung Infection and Immunity, Department of Medicine, Division of Pulmonology and UCT Lung Institute, University of Cape Town, Cape Town, South Africa, University of Cape Town Lung Institute & South African MRC Centre for the Study of Antimicrobial Resistance, Cape Town, South Africa, Faculty of Infectious and Tropical Diseases, Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK.
²² Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia, Woolcock Institute of Medical Research, Glebe, NSW, Australia.
²³ Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa.
²⁴ Department of Genetics, University of Cambridge, Cambridge, UK.
²⁵ Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW, Australia, Department of Infectious Diseases and Microbiology, The Children´s Hospital at Westmead, Westmead, NSW, Australia.
²⁶ Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
²⁷ Antimicrobial Pharmacodynamics and Therapeutics, Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
²⁸ Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México, Mexico.
²⁹ Division of Paediatric Respirology, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia.
³⁰ Infectious Disease Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Institute for Health Innovation & Technology (iHealthtech), National University of Singapore, Singapore, Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore.
³¹ German Central Committee against Tuberculosis (DZK), Berlin, Germany.
³² Infectious Disease Pharmacokinetics Laboratory, Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL, USA.
³³ Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
³⁴ TB/HIV Research Centre, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia, Department of Biomedical Sciences, Division of Pharmacology and Therapy, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
³⁵ Division of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia.
³⁶ Department of Bioengineering and Therapeutic Sciences, Division of Pulmonary and Critical Care Medicine, Schools of Pharmacy and Medicine, University of California San Francisco, San Francisco, CA, USA.
³⁷ Department of TB & Respiratory Diseases, National Institute of TB & Respiratory Diseases, New Delhi, India.
³⁸ Department of Pharmacy, Radboud Institute for Health Sciences & Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands, Department of Pharmacy, Uppsala University, Uppsala, Sweden.
³⁹ The Republican Research and Practical Centre for Pulmonology and TB, Minsk, Belarus.
⁴⁰ National Institute for Public Health and the Environment, TB Reference Laboratory (RIVM), Bilthoven, The Netherlands.
⁴¹ Department of Pulmonary Immunology, University of Texas Health Science Center at Tyler, Tyler, TX, USA.
⁴² Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
⁴³ Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
⁴⁴ P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, India.
⁴⁵ National Drug Information and Adverse Drug Reaction Monitoring Centre, Hanoi University of Pharmacy, Hanoi, Vietnam.
⁴⁶ Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People´s Republic of China.
⁴⁷ Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania, Kibong´oto Infectious Diseases Hospital, Sanya Juu, Siha, Kilimanjaro, United Republic of Tanzania.
⁴⁸ Department of Infectious Diseases, Linköping University Hospital, Linköping, Sweden, Institute of Biomedical and Clinical Sciences, Division of Infection and Inflammation, Linköping University, Linköping, Sweden, Department of Infectious Diseases, Kalmar County Hospital, Kalmar, Linköping University, Linköping, Sweden.

PMID: 35650702
PMCID: PMC9165737
DOI: 10.5588/ijtld.22.0188

Clinical standards for the dosing and management of TB drugs

J W C Alffenaar et al. Int J Tuberc Lung Dis. 2022.

. 2022 Jun 1;26(6):483-499.

doi: 10.5588/ijtld.22.0188.

Authors

Affiliations

¹ Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW, Australia, School of Pharmacy, The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia, Westmead Hospital, Sydney, NSW, Australia.
² School of Pharmacy, The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia, Department of Clinical Pharmacology and Toxicology, St Vincent´s Hospital, Sydney, NSW, Australia, St Vincent´s Clinical Campus, University of NSW, Kensington, NSW, Australia.
³ Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Solna, Sweden, Department of Infectious Diseases Karolinska University Hospital, Solna, Sweden.
⁴ Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa, Department of Pediatrics, University of Wisconsin, Madison, WI.
⁵ Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
⁶ Department of Pharmacy, Radboud Institute for Health Sciences & Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
⁷ University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Groningen, The Netherlands, University of Groningen, University Medical Center Groningen, Tuberculosis Center Beatrixoord, Haren, The Netherlands.
⁸ Educational Institution "Grodno State Medical University", Grodno, Belarus.
⁹ Asian Harm Reduction Network (AHRN) and Medical Action Myanmar (MAM) in Yangon, Myanmar.
¹⁰ Belgian Scientific Institute for Public Health (Belgian Lung and Tuberculosis Association), Brussels, Belgium.
¹¹ Indian Council of Medical Research-National Institute for Research in Tuberculosis-International Center for Excellence in Research, Chennai, India.
¹² Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Department of Public Health TB Control, Metropolitan Public Health Services, The Hague, The Netherlands.
¹³ Laboratório de Inovações em Terapias, Ensino e Bioprodutos (LITEB), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
¹⁴ Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Italy.
¹⁵ Department of Medicine, Therapeutics and Dermatology, Kenyatta University, Nairobi, Kenya, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
¹⁶ Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
¹⁷ Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW, Australia, Westmead Hospital, Sydney, NSW, Australia, Parramatta Chest Clinic, Parramatta, NSW, Australia.
¹⁸ Public Health Consulting Group, Lugano, Switzerland.
¹⁹ Reference Center Hélio Fraga, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil.
²⁰ Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
²¹ Centre for Lung Infection and Immunity, Department of Medicine, Division of Pulmonology and UCT Lung Institute, University of Cape Town, Cape Town, South Africa, University of Cape Town Lung Institute & South African MRC Centre for the Study of Antimicrobial Resistance, Cape Town, South Africa, Faculty of Infectious and Tropical Diseases, Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK.
²² Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia, Woolcock Institute of Medical Research, Glebe, NSW, Australia.
²³ Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa.
²⁴ Department of Genetics, University of Cambridge, Cambridge, UK.
²⁵ Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW, Australia, Department of Infectious Diseases and Microbiology, The Children´s Hospital at Westmead, Westmead, NSW, Australia.
²⁶ Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
²⁷ Antimicrobial Pharmacodynamics and Therapeutics, Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
²⁸ Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México, Mexico.
²⁹ Division of Paediatric Respirology, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia.
³⁰ Infectious Disease Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Institute for Health Innovation & Technology (iHealthtech), National University of Singapore, Singapore, Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore.
³¹ German Central Committee against Tuberculosis (DZK), Berlin, Germany.
³² Infectious Disease Pharmacokinetics Laboratory, Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL, USA.
³³ Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
³⁴ TB/HIV Research Centre, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia, Department of Biomedical Sciences, Division of Pharmacology and Therapy, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
³⁵ Division of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia.
³⁶ Department of Bioengineering and Therapeutic Sciences, Division of Pulmonary and Critical Care Medicine, Schools of Pharmacy and Medicine, University of California San Francisco, San Francisco, CA, USA.
³⁷ Department of TB & Respiratory Diseases, National Institute of TB & Respiratory Diseases, New Delhi, India.
³⁸ Department of Pharmacy, Radboud Institute for Health Sciences & Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands, Department of Pharmacy, Uppsala University, Uppsala, Sweden.
³⁹ The Republican Research and Practical Centre for Pulmonology and TB, Minsk, Belarus.
⁴⁰ National Institute for Public Health and the Environment, TB Reference Laboratory (RIVM), Bilthoven, The Netherlands.
⁴¹ Department of Pulmonary Immunology, University of Texas Health Science Center at Tyler, Tyler, TX, USA.
⁴² Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
⁴³ Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
⁴⁴ P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, India.
⁴⁵ National Drug Information and Adverse Drug Reaction Monitoring Centre, Hanoi University of Pharmacy, Hanoi, Vietnam.
⁴⁶ Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People´s Republic of China.
⁴⁷ Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania, Kibong´oto Infectious Diseases Hospital, Sanya Juu, Siha, Kilimanjaro, United Republic of Tanzania.
⁴⁸ Department of Infectious Diseases, Linköping University Hospital, Linköping, Sweden, Institute of Biomedical and Clinical Sciences, Division of Infection and Inflammation, Linköping University, Linköping, Sweden, Department of Infectious Diseases, Kalmar County Hospital, Kalmar, Linköping University, Linköping, Sweden.

PMID: 35650702
PMCID: PMC9165737
DOI: 10.5588/ijtld.22.0188

Abstract
in English, French

BACKGROUND: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on 'best practice´ for dosing and management of TB drugs.METHODS: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants.RESULTS: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified.CONCLUSION: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.

CONTEXTE :: Une posologie optimale est importante afin de garantir une réponse adéquate au traitement, de prévenir le développement de résistances aux médicaments et de réduire la toxicité liée aux médicaments. L’objectif de ces normes cliniques est de donner des indications de « bonne pratique » en matière de posologie et de gestion des agents antituberculeux.

MÉTHODES :: Un panel de 57 experts internationaux spécialisés en microbiologie, pharmacologie et soins antituberculeux a été identifié ; 51 ont participé à un processus Delphi. Une échelle de Likert à 5 points a été utilisée pour noter les premières ébauches des normes. Le document final est fondé sur un large consensus puisqu’il a été approuvé par tous les participants.

RÉSULTATS :: Six normes cliniques ont été définies : Norme 1, définir la dose initiale la mieux adaptée au traitement de la TB ; Norme 2, identifier les patients potentiellement à risque d’exposition sous-optimale aux médicaments ; Norme 3, identifier les patients à risque de développer une toxicité liée aux médicaments et déterminer comment diminuer au mieux ce risque ; Norme 4, identifier les patients pouvant bénéficier d’un suivi thérapeutique pharmacologique (TDM) ; Norme 5, définir les informations et conseils à fournir aux patients placés sous traitement antituberculeux et Norme 6, enseigner les fondamentaux aux professionnels de santé. Les priorités de recherche ont également été définies, sur la base d’un consensus.

CONCLUSION :: Il s’agit des premières normes cliniques, fondées sur un consensus, en matière de posologie et de gestion des antituberculeux. Elles ont pour objectif d’orienter les cliniciens et les responsables de programme en matière de planification et de mise en place de mesures locales adéquates pour un traitement optimal centré sur le patient, afin d’améliorer la prise en charge.

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Conflict of interest statement

Conflicts of interest: CUK is a consultant for FIND and the TB Alliance (Geneva, Switzerland). CUK’s consulting work for Becton Dickinson (BD; Franklin Lakes, NJ, USA) involves a collaboration with Janssen (Beerse, Belgium) and Thermo Fisher Scientific (Waltham, MA, USA). CUK is collaborating with PZA Innovation (Baltimore, MD, USA). CUK worked as a consultant for QuantuMDx (Newcastle upon Tyne, UK), the Stop TB Partnership, the WHO Global TB Programme, and the WHO Regional Office for Europe. CUK gave a paid educational talk for Oxford Immunotec (Abingdon, UK). Hain Lifescience (Nehren, Germany) covered CUK’s travel and accommodation to present at a meeting. CUK is an unpaid advisor to BioVersys (Basel, Switzerland) and GenoScreen (Lille, France). GJF has received in-kind support from Sanofi Pharmaceuticals (Paris, France) to provide rifapentine for a clinical trial. DMC has participated to studies for the evaluation of epidemiologic cut-off values and critical concentrations for bedaquiline (Janssen), pretomanid (TBA Pharma; Ouagadougou, Burkina Faso), delamanid (Otsuka; Tokyo, Japan) from 2016-2022. CWMO has received speaking fees from Qiagen (Hilden, Germany) outside this work.

Figures

**Figure**
Factors contributing to variability in pharmacokinetics, as well as the efficacy and toxicity of drugs used to treat TB.* *Factors which are likely (black), might (light grey) or are unlikely (white) to contribute to variability in drug efficacy or toxicity and which should be considered when making drug selections or dose adjustments. ^†WHO-recommended doses for adults. ^‡Reference values for C_max after a standard dose. ^§The PK/PD targets were previously reported and are dependent on the precise MIC methodology used in the respective studies. Because of the systematic differences between some MIC methods, these targets cannot be used directly with some MIC methods. The PK/PD targets should be used in a multiprofessional team experienced in TDM. ^¶Reference values for C_max after standard dose. ^**Reference value for C_max after standard dose. TDM=therapeutic drug monitoring; C_max=maximum concentration (of a drug); RIF = rifampicin; AUC = area under the curve; INH = isoniazid; EMB= ethambutol; PZA = pyrazinamide; MFX ¼moxifloxacin; LVX = levofloxacin; LZD = linezolid; BDQ = bedaquiline; CFZ = clofazimine; CS = cycloserine; TRD = terizidone; DLM = delamanid; IPM/CIL = imipenem/cilastatin; MER = meropenem; AMK = amikacin; ETH = ethionamide; PTH = prothionamide; PAS = para-aminosalicylic acid; Pa = pretomanid; MIC = minimum inhibitory concentration; fAUC = free area under the concentration time curve; C_min = minimum concentration (of a drug); PK = pharmacokinetics; PD = pharmacodynamics.

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Comment in

New standards for precision medicine in TB management.
Triccas JA, McLachlan AJ. Triccas JA, et al. Int J Tuberc Lung Dis. 2022 Jun 1;26(6):481-482. doi: 10.5588/ijtld.22.0222. Int J Tuberc Lung Dis. 2022. PMID: 35650696 No abstract available.

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Clinical standards for the dosing and management of TB drugs

Affiliations

Clinical standards for the dosing and management of TB drugs

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Abstract
in English, French

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Abstract
in English, French