Pharmacokinetic Study of Linezolid for TB Meningitis
Maneno muhimu
Kikemikali
Maelezo
Overall aim is to determine the most appropriate dose of linezolid in the treatment of TB meningitis, when combined with high-dose rifampicin (35 mg/kg orally), to be tested in larger clinical follow-up studies.
Tarehe
Imethibitishwa Mwisho: | 06/30/2020 |
Iliyowasilishwa Kwanza: | 05/01/2018 |
Uandikishaji uliokadiriwa Uliwasilishwa: | 05/13/2018 |
Iliyotumwa Kwanza: | 05/24/2018 |
Sasisho la Mwisho Liliwasilishwa: | 07/01/2020 |
Sasisho la Mwisho Lilichapishwa: | 07/06/2020 |
Tarehe halisi ya kuanza kwa masomo: | 07/31/2020 |
Tarehe ya Kukamilisha Msingi iliyokadiriwa: | 12/31/2020 |
Tarehe ya Kukamilisha Utafiti: | 03/31/2021 |
Hali au ugonjwa
Uingiliaji / matibabu
Drug: Linezolid
Awamu
Vikundi vya Arm
Mkono | Uingiliaji / matibabu |
---|---|
No Intervention: Control arm Subjects in this arm will only receive high-dose rifampicin (~35 mg/kg, based on weight), isoniazid (H) 300 mg, pyrazinamide (Z) 1500 mg and ethambutol (E) 750 mg once daily administered orally for 14 days.
High-dose rifampicin will consist of weight-banded fixed-dose combination (FDC), including rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) according to international guidelines, combined with 900 mg rifampicin (≤37 kg: two 450 mg tablets) or 1200 mg rifampicin (>37 kg: two 600 mg tablets) to reach ~35 mg/kg rifampicin in total. | |
Experimental: Linezolid 600 Subjects in this arm will receive 600 mg linezolid QD along with high-dose rifampicin (~35 mg/kg, based on weight), isoniazid (H) 300 mg, pyrazinamide (Z) 1500 mg and ethambutol (E) 750 mg once daily administered orally for 14 days. | |
Experimental: Linezolid 1200 Subjects in this arm will receive 1200 mg linezolid QD along with rifampicin 1350 mg (~35 mg/kg, based on weight), isoniazid (H) 300 mg, pyrazinamide (Z) 1500 mg and ethambutol (E) 750 mg once daily administered orally for 14 days. |
Vigezo vya Kustahiki
Zama zinazostahiki Kujifunza | 18 Years Kwa 18 Years |
Jinsia Inastahiki Kujifunza | All |
Hupokea Wajitolea wa Afya | Ndio |
Vigezo | Inclusion Criteria: - Age: 18 years old or older - Clinically diagnosed as TB meningitis patient - CSF/blood glucose ratio < 0.5 - Willing to participate in the study by signing informed consent Exclusion Criteria: Patients who have one of the following criteria will be excluded: - Failure to diagnostic lumbar puncture - Confirmed cryptococcus meningitis (LFA) in HIV-positive patients; or diagnosed as bacterial meningitis based on clinical assessment and routine CSF examination. - Treatment for tuberculosis for more than 3 days before admission - History of TBM - Current treatment with: MAO inhibitors, direct and indirect acting sympathomimetic drugs, vasopressive drugs, dopaminergic compounds, buspiron, serotonin reuptake inhibitors, tricyclic antidepressants, triptans, tramadol and meperidine - History (< 2 weeks before start of linezolid) of taking any MAO inhibitors - Pregnant or lactating females - Hepatic insufficiency (ALT>5x upper normal limit) - Kidney dysfunction (eGFR <50ml/min) - Known hypersensitivity to rifampicin and/or linezolid - Rapid clinical deterioration at time of presentation (sepsis, decreasing consciousness, or signs of cerebral oedema or herniation) |
Matokeo
Hatua za Matokeo ya Msingi
1. Linezolid exposure in blood and CSF [day 2 and day 11]
Hatua za Matokeo ya Sekondari
1. Serious adverse event [Day 3, 7, 10 and 14]
2. Clinical response [Day 3, 7 and 14.]
3. Neurological response [Day 3, 7 and 14.]
4. Mortality [Within 14 days and 1 month after starting treatment]
5. Blood inflammatory response [at PK days (day 2 and 11), and day 7 and 14]
6. CSF inflammatory response [at PK sampling days (day 2 and 11)]