A significant influence of metronidazole on busulfan pharmacokinetics: A case report of therapeutic drug monitoring

Hyewon Chung; Kyung Sang Yu; Kyung Taek Hong; Jung Yoon Choi; Che Ry Hong; Hyoung Jin Kang; Kyung Duk Park; Hee Young Shin; Seung Hwan Lee

doi:10.1097/FTD.0000000000000395

A significant influence of metronidazole on busulfan pharmacokinetics: A case report of therapeutic drug monitoring

Hyewon Chung, Kyung Sang Yu, Kyung Taek Hong, Jung Yoon Choi, Che Ry Hong, Hyoung Jin Kang, Kyung Duk Park, Hee Young Shin, Seung Hwan Lee

Research output: Contribution to journal › Article › peer-review

15 Scopus citations

Abstract

Busulfan is a cytotoxic agent used in preconditioning for hematopoietic stem cell transplantation. Therapeutic drug monitoring of busulfan is necessary owing to its narrow therapeutic range. Patients undergoing preconditioning are susceptible to infection and might require coadministration of antibiotics. We present a case study of a 3-year-old girl with precursor T-cell acute lymphoblastic leukemia who received intravenous busulfan before hematopoietic stem cell transplantation. Metronidazole was coadministered before the third dose of busulfan because of Clostridium difficile infection. The daily pharmacokinetic analysis revealed that the clearance reduced to 57% of that before the coadministration. Although the underlying mechanism is unclear, a significant pharmacokinetic interaction was observed between busulfan and metronidazole, underscoring the importance of therapeutic drug monitoring.

Original language	English
Pages (from-to)	208-210
Number of pages	3
Journal	Therapeutic Drug Monitoring
Volume	39
Issue number	3
DOIs	https://doi.org/10.1097/FTD.0000000000000395
State	Published - 1 Jun 2017

Bibliographical note

Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc.

Keywords

Drug interaction
Pharmacokinetics
Therapeutic drug monitoring

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10.1097/FTD.0000000000000395

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title = "A significant influence of metronidazole on busulfan pharmacokinetics: A case report of therapeutic drug monitoring",

abstract = "Busulfan is a cytotoxic agent used in preconditioning for hematopoietic stem cell transplantation. Therapeutic drug monitoring of busulfan is necessary owing to its narrow therapeutic range. Patients undergoing preconditioning are susceptible to infection and might require coadministration of antibiotics. We present a case study of a 3-year-old girl with precursor T-cell acute lymphoblastic leukemia who received intravenous busulfan before hematopoietic stem cell transplantation. Metronidazole was coadministered before the third dose of busulfan because of Clostridium difficile infection. The daily pharmacokinetic analysis revealed that the clearance reduced to 57% of that before the coadministration. Although the underlying mechanism is unclear, a significant pharmacokinetic interaction was observed between busulfan and metronidazole, underscoring the importance of therapeutic drug monitoring.",

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AU - Choi, Jung Yoon

AU - Hong, Che Ry

AU - Kang, Hyoung Jin

AU - Park, Kyung Duk

AU - Shin, Hee Young

AU - Lee, Seung Hwan

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AB - Busulfan is a cytotoxic agent used in preconditioning for hematopoietic stem cell transplantation. Therapeutic drug monitoring of busulfan is necessary owing to its narrow therapeutic range. Patients undergoing preconditioning are susceptible to infection and might require coadministration of antibiotics. We present a case study of a 3-year-old girl with precursor T-cell acute lymphoblastic leukemia who received intravenous busulfan before hematopoietic stem cell transplantation. Metronidazole was coadministered before the third dose of busulfan because of Clostridium difficile infection. The daily pharmacokinetic analysis revealed that the clearance reduced to 57% of that before the coadministration. Although the underlying mechanism is unclear, a significant pharmacokinetic interaction was observed between busulfan and metronidazole, underscoring the importance of therapeutic drug monitoring.

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A significant influence of metronidazole on busulfan pharmacokinetics: A case report of therapeutic drug monitoring

Abstract

Bibliographical note

Keywords

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