| The treatment of tuberculosis (TB) is complicated by problems of non-adherence, inadequate response, resistance development to TB drugs and drug-related adverse effects. These issues can be considered as related to each other, with TB drug concentrations serving as an intermediary link. A previous study in an Indonesian TB clinic revealed that plasma concentrations of the key first-line TB drug rifampicin were very low in Indonesian TB patients. We will study the determinants of the low rifampicin concentrations in Indonesian patients, the relationship between rifampicin concentrations and response, and the merits of increasing the dose of rifampicin in Indonesian patients in a prospective cohort study and clinical trial at the TB Research and Clinical Trial Center in Bandung, Indonesia, embedded in the Indonesian-Tanzanian-Dutch Collaboration PRIOR. The research findings may help to optimize current therapy and to evaluate possible new drugs. This is highly relevant, especially in the light of growing rates of MDR-TB and concomitant HIV-TB infection in Indonesia. |
