Plasma pharmacokinetics of bedaquiline administered by nasogastric tube in an intensive care unit.

Plasma pharmacokinetics of bedaquiline administered by nasogastric tube in an intensive care unit.

Dang, E;Sayagh, F;Lê, M P;Neuville, M;Sinnah, F;Timsit, J-F;Peytavin, G;
the international journal of tuberculosis and lung disease : the official journal of the international union against tuberculosis and lung disease 2020 Vol. 24 pp. 110-112
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dang2020plasmathe

Abstract

We present the case of a 21-year-old man admitted to the intensive care unit with multi-organ failure due to multidrug-resistant tuberculosis (TB). TB treatment initially comprised moxifloxacin, ethambutol, linezolid and amikacin administered intravenously. Due to suspected moxifloxacin-induced liver injury, we stopped all fluoroquinolones and switched to bedaquiline (BDQ), which is only available in tablets for oral administration. Since our patient had to be fed through a nasogastric tube (NGT), BDQ was administered after being crushed and dissolved in water; drug pharmacokinetics were studied using repeated blood sampling. Therapeutic drug monitoring showed that BDQ was detectable in blood plasma with a trough concentration above the supposed efficacy threshold, suggesting that this molecule could be administered through NGT.

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