Towards utilizing the full potential of old – but not outdated – drugs for tuberculosis and nontuberculous mycobacterial disease: A clinical pharmacological perspective

Multiple antibiotics are combined to treat tuberculosis (TB) and non-tuberculous mycobacterial (NTM) disease. Although many of these antibiotics have been used for decades, the optimal dose is often unknown. This thesis focuses on studying concentrations of different antibiotics in the body, because concentrations are the link between the dose and effect. It was shown that pyrazinamide penetrates well into the cerebrospinal fluid of patients with TB in the brain, further supporting the importance of this drug. The potency of rifampicin to cause interactions with other drugs was found to be only mildly increased when a higher, probably more effective, dose of rifampicin was used in patients with TB. Using a higher starting dose of clofazimine shortened the time to reach stable blood concentrations by months in patients with NTM disease. The findings from this thesis contribute to optimization of the use of these drugs for TB and NTM infections.