title: Effect of a 150 mg dose of rifabutin on serum itraconazole levels in patients with coexisting chronic pulmonary aspergillosis and Mycobacterium avium complex lung disease.
abstract: Patients with coexisting chronic pulmonary aspergillosis and nontuberculous mycobacterial lung disease may undergo treatment with both the antifungal itraconazole and the antimycobacterial rifamycin. However, rifamycins interact with itraconazole. We examined the effects of a 150 mg dose of rifabutin on serum itraconazole levels and found significantly lower levels in 28 patients receiving itraconazole with rifabutin (median, 0.65 μg/ml) compared with 65 patients receiving itraconazole alone (median 3.45 μg/ml, P < 0.001). One-third of patients receiving itraconazole and rifabutin reached the therapeutic range of serum itraconazole concentration. Therapeutic drug monitoring is strongly recommended during concomitant use of rifabutin and itraconazole.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Seong Mi
authors.initials: SM
authors.lastname: Moon
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea.
authors.forename: Byung Woo
authors.initials: BW
authors.lastname: Jhun
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Hye Yun
authors.initials: HY
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.affiliation: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Soo-Youn
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: wjkoh@skku.edu.
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000097:blood*; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D055732:Pulmonary Aspergillosis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D017828:Rifabutin / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D017828:Rifabutin; D017964:Itraconazole
keywords: Chronic pulmonary aspergillosis; Itraconazole; Mycobacterium avium complex; Nontuberculous mycobacteria; Rifabutin