Trial reportAntimicrobial agents and chemotherapy2012
Ethambutol pharmacokinetic variability is linked to body mass in overweight, obese, and extremely obese people.
Trial report in Antimicrobial agents and chemotherapy, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01048697 (Population Pharmacokinetics Analysis of Ethambutol in Overweight and Obese Volunteers), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Population Pharmacokinetics Analysis of Ethambutol in Overweight and Obese Volunteers
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Updated antimicrobial dosing recommendations for obese patients.Antimicrobial agents and chemotherapy · 2024Pooled it
- Pharmacokinetics of ethambutol and weight banded dosing in South African adults newly diagnosed with tuberculosis and HIV.Antimicrobial agents and chemotherapy · 2025Trial
- Supervised Machine-Learning Reveals That Old and Obese People Achieve Low Dapsone Concentrations.CPT: pharmacometrics & systems pharmacology · 2017Trial
- Fractal Geometry-Based Decrease in Trimethoprim-Sulfamethoxazole Concentrations in Overweight and Obese People.CPT: pharmacometrics & systems pharmacology · 2016Trial
- Ethambutol Population Pharmacokinetics and Pharmacodynamics From a Phase 3 Confirmatory Trial for the Treatment of Tuberculosis.The Journal of infectious diseases · 2026Article
- Association between urinary antibiotic exposure and blood pressure parameters in reproductive-age men: a biomonitoring-based cross-sectional study in China.Translational andrology and urology · 2026Article
- Preclinical pharmacokinetics/pharmacodynamics studies defining the role of ethambutol inAntimicrobial agents and chemotherapy · 2026Article
- Genetic polymorphism related to ethambutol outcomes and susceptibility to toxicity.Frontiers in genetics · 2023Review
- Clinical Pharmacokinetic and Pharmacodynamic Considerations in the Drug Treatment of Non-Tuberculous Mycobacteria in Cystic Fibrosis.Clinical pharmacokinetics · 2021Review
- Population Pharmacokinetics and Bayesian Dose Adjustment to Advance TDM of Anti-TB Drugs.Clinical pharmacokinetics · 2021Review
- Optimizing ethambutol dosing among HIV/tuberculosis co-infected patients: a population pharmacokinetic modelling and simulation study.The Journal of antimicrobial chemotherapy · 2019Article
- The Sterilizing Effect of Intermittent Tedizolid for Pulmonary Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Article
- Global Urine Metabolomics in Patients Treated with First-Line Tuberculosis Drugs and Identification of a Novel Metabolite of Ethambutol.Antimicrobial agents and chemotherapy · 2016Article
- Article
- Amikacin Concentrations Predictive of Ototoxicity in Multidrug-Resistant Tuberculosis Patients.Antimicrobial agents and chemotherapy · 2015Article
- Serum drug concentrations predictive of pulmonary tuberculosis outcomes.The Journal of infectious diseases · 2013Article
- Interaction of Ethambutol with human organic cation transporters of the SLC22 family indicates potential for drug-drug interactions during antituberculosis therapy.Antimicrobial agents and chemotherapy · 2013Article
- Weight drives caspofungin pharmacokinetic variability in overweight and obese people: fractal power signatures beyond two-thirds or three-fourths.Antimicrobial agents and chemotherapy · 2013Article
- Pegylated interferon fractal pharmacokinetics: individualized dosing for hepatitis C virus infection.Antimicrobial agents and chemotherapy · 2013Article
- Association between overweight/obesity and multidrug-resistant tuberculosis.Revista peruana de medicina experimental y salud publicaArticle
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 1 country.
Funding
Abstract
We conducted a prospective study of 18 adult volunteers (male-to-female ratio of 1) whose body mass index fell into categories of <25, 25 to 40, or >40 kg/m(2), who received a single oral dose of 1,600 mg ethambutol. Only individuals with normal renal function were recruited. The minimum body mass (M) was 45.6 kg, the median was 90.8 kg, and the maximum weight was 160.4 kg. Ethambutol pharmacokinetics were best described by a two-compartment model. Inclusion of weight as a covariate dramatically improved the model, with a relative likelihood approaching infinity. The typical clearance was 42.6 liters/h. Ethambutol systemic clearance was proportional to (M/45.6)(3/4) and thus obeyed fractal geometry-based laws. This means that the area under the concentration-time curve (AUC) actually decreased for obese patients compared to that for leaner patients, reducing chances of concentration-dependent toxicity. On the other hand, such reduced AUCs could lead to therapy failure. Thus, new and individualized ethambutol dosing regimens need to be designed for obese and extremely obese patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.