Rifamycins exhibit concentration-dependent killing of Mycobacterium tuberculosis; higher exposures potentially induce better outcomes. We randomized 180 tuberculosis patients in Peru to 10, 15, and 20 mg/kg/day of rifampin. 168 had noncompartmental pharmacokinetic analyses: 67% were sampled twice; 33% six times. Doses were well-tolerated. Median (interquartile range) AUC0-6 was 24.9 (17.6-32.1), 43.1 (30.3-57.5), and 55.5 (35.7-73.2) h*mcg/mL; median Cmax in the experimental arms reached the target of 8 mcg/mL. Continued investigation of higher rifampin doses is warranted.
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