{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:32:24Z","timestamp":1786977144873,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["72067418CA00006"],"award-info":[{"award-number":["72067418CA00006"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["222075\/Z\/20\/Z"],"award-info":[{"award-number":["222075\/Z\/20\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"abstract":"<jats:p>Levofloxacin is a widely used antibiotic included in rifampicin\u2010resistant tuberculosis (RR\u2010TB) treatment. Data describing levofloxacin concentrations in breastmilk and infant exposure are limited. We analysed data from two South African studies of breastfeeding women receiving levofloxacin (750\u20131000\u2009mg daily) for RR\u2010TB. Plasma and breastmilk samples were collected over eight hours, \u22655\u00a0weeks postpartum. A single plasma sample was obtained from breastfed infants. Twenty women contributed paired plasma\u2010breastmilk samples, 15 plasma concentrations from breastfed infants were available. Using nonlinear mixed\u2010effects modelling, levofloxacin equilibrated rapidly between plasma and breastmilk (7.50\u2009min half\u2010life; 95% CI: 3.89\u201311.5), with a breastmilk: plasma ratio of 1.46 (95% CI: 1.40\u20131.52). The relative infant dose through breastfeeding was 6\u20138% of the recommended 15\u201320\u2009mg\/kg\/day adult and paediatric dose, confirmed by low (but detectable) concentrations in some infants. It is unclear whether these low infant concentrations may be prophylactic or instead contribute to the development of drug resistance.<\/jats:p>","DOI":"10.1002\/bcp.70386","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T23:34:31Z","timestamp":1764718471000},"source":"Crossref","is-referenced-by-count":1,"title":["Population pharmacokinetics of levofloxacin in breastmilk in patients with rifampicin\u2010resistant tuberculosis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7251-8546","authenticated-orcid":false,"given":"Sharon","family":"Sawe","sequence":"first","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lufina","family":"Tsirizani","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buyisile","family":"Mkhize","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lubbe","family":"Wiesner","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3080-6606","authenticated-orcid":false,"given":"Gary","family":"Maartens","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Conradie","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Court","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Loveday","sequence":"additional","affiliation":[{"name":"HIV and other Infectious Diseases Research Unit, South African Medical Research Council  KwaZulu\u2010Natal South Africa"},{"name":"CAPRISA\u2010MRC HIV\u2010TB Pathogenesis and Treatment Research Unit  KwaZulu\u2010Natal South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona","family":"Waitt","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute College of Health Sciences, Makerere University  Kampala Uganda"},{"name":"Department of Women's and Children's Health University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7494-079X","authenticated-orcid":false,"given":"Paolo","family":"Denti","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40262\u2010024\u201001432\u2010w"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics15041228"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.20.0122"},{"key":"e_1_2_10_5_1","unstructured":"World Health Organization.WHO Consolidated Guidelines on Tuberculosis Module 4: Treatment Drug\u2010Resistant Tuberculosis Treatment 2022 Update. 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