Evidence map›Paper›PMID 40441696›Full record

ArticleBritish journal of clinical pharmacology2025

Population pharmacokinetics and dosing of dispersible moxifloxacin formulation in children with rifampicin-resistant tuberculosis.

Megan Palmer, Yuanxi Zou, Anneke C Hesseling, Louvina van der Laan, Ingrid Courtney, Aarti A Kinikar, Naresh Sonkawade, Mandar Paradkar, Vandana Kulkarni, Dessa Jean O Casalme and 7 more

Abstract readMulticenter Study
In one paragraph

Article in British journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Megan PalmerDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-2534-2483
Yuanxi ZouDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0003-0547-390X
Anneke C HesselingDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Louvina van der LaanDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-3584-7477
Ingrid CourtneyDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Aarti A KinikarB.J. Government Medical College, Pune, India.ORCID https://orcid.org/0000-0001-9466-1130
Naresh SonkawadeB.J. Government Medical College, Pune, India.ORCID https://orcid.org/0000-0002-8164-6641
Mandar ParadkarBJ Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India.ORCID https://orcid.org/0000-0001-9843-4656
Vandana KulkarniBJ Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India.ORCID https://orcid.org/0000-0002-3488-2692
Dessa Jean O CasalmeDe La Salle Health Sciences Institute, Dasmarinas, The Philippines.
Melchor V G FriasDe La Salle Health Sciences Institute, Dasmarinas, The Philippines.
Heather DraperDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Lubbe WiesnerDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-9070-8699
Mats O KarlssonDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0003-1258-8297
Paolo DentiDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-7494-079X
Elin M SvenssonDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0002-0093-6445
Anthony J Garcia-PratsDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-9280-1950

Funding

Unitaid
6 · The paper itself

Abstract

aimsMoxifloxacin is a priority drug for treating rifampicin-resistant tuberculosis (RR-TB). We assessed the pharmacokinetics of a child-friendly, dispersible 100 mg tablet moxifloxacin formulation (dispersed in water) compared to the standard 400 mg non-dispersible formulation (crushed and suspended in water) in children and evaluated current dosing recommendations.

methodsThe CATALYST trial investigated the pharmacokinetics of moxifloxacin in children with RR-TB. Children were enrolled in South Africa, India and the Philippines. Intensive pharmacokinetic sampling was undertaken while children were taking the standard non-dispersible 400 mg moxifloxacin tablet formulation and repeated after switching to the novel dispersible formulation. Pharmacokinetic data were analysed using population pharmacokinetic modelling. Simulations were performed to evaluate moxifloxacin exposures in children compared to consensus adult reference exposures using current World Health Organization (WHO)-recommended doses and more recent model-based doses.

resultsThirty-six children were enrolled [median age 4.8 (range 0.4-15) years and weight 15.6 (range 6.9-42.1) kg]. A two-compartment disposition model with first-order elimination and delayed absorption was developed. The bioavailability of dispersible versus standard formulations fulfilled standard bioequivalence criterion (ratio 1.05 with 90% confidence interval 0.95-1.15). Simulations showed WHO-recommended doses achieved exposures similar to those in adults in children >10 kg, while children <10 kg may require 33%-56% higher doses to reach adult reference exposures.

conclusionsDosing recommendations for children can be the same for the dispersible paediatric and standard non-dispersible adult moxifloxacin formulation. The current WHO dosing recommendation risks underdosing moxifloxacin in children <10 kg. We propose optimized moxifloxacin doses for both formulations.

Indexed as

Antitubercular AgentsFluoroquinolonesMoxifloxacinTuberculosis, Multidrug-ResistantAdolescentBiological AvailabilityChildChild, PreschoolFemaleHumansInfantMaleModels, BiologicalRifampinTabletsAntitubercular AgentsFluoroquinolonesMoxifloxacinRifampinTabletschild‐friendly formulationmoxifloxacinpaediatric dosingpaediatric tuberculosispopulation pharmacokinetics

Identifiers

PMID40441696
PMCPMC12122143

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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.