Pharmacokinetic optimization of the treatment of TB meningitis with TB drugs
Robert Hofstra, Noriyuki Koibuchi, Suthat Fucharoen in Advances in Biomolecular Medicine, 2017
A higher dose of i.v. rifampicin seems promising to achieve a better outcome of TBM treatment. However i.v. rifampicin is not easy; it is invasive, impractical, more expensive than oral drug, and not widely available. For this reason, first, we need to find an alternative for intravenous rifampicin that gives the same effect, i.e. a higher oral dose of rifampicin (i.e. 15 or 20 mg/kg, or even higher) with a similar PK/PD and safety profile to those of i.v. rifampicin. Rifampicin is a widely used drug and tolerated well by patients. In addition, it has been shown that a higher oral dose of rifampicin up to 35 mg/kg is well tolerated in African pulmonary TB patients (Boeree et al., 2015).
Rifampicin (Rifampin)
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Rifampicin is a first-line agent for treatment of all forms of tuberculosis caused by organisms with known or presumed susceptibility to the drug. It has demonstrated early bactericidal activity (Jindani et al., 1980; Donald and Diacon, 2008), and also activity against semi-dormant bacterial populations, thus accounting for its sterilizing activity (Dickinson and Mitchison, 1981; Jindani et al., 2003).
Chemotherapy Including Drug-Resistant Therapy
Peter D O Davies, Stephen B Gordon, Geraint Davies in Clinical Tuberculosis, 2014
The minimum duration of therapy with rifampicin-based regimens is currently believed to be six months. A number of systematic reviews have concluded that there is a relationship between the duration of rifampicin included in the regimen and the relapse rate following therapy supporting the recent recommendation to move to regimens that use rifampicin throughout treatment [41,42].
Rifampicin ameliorates lipopolysaccharide-induced cognitive and motor impairments via inhibition of the TLR4/MyD88/NF-κB signaling pathway in mice
Published in Neurological Research, 2021
Wei Bi, Xiaofeng Cheng, Zhaohao Zeng, Ruiyi Zhou, Rixin Luo, Jiawei Zhang, Lihong Zhu
Rifampicin is a macrocyclic antibiotic used extensively against Mycobacterium tuberculosis and other mycobacterial infections[13]. Studies dating back to the 1970s have demonstrated that rifampicin exerts immunomodulatory effects[14]. Early investigations in mouse models revealed that rifampicin prolongs the survival of heart allografts by suppressing humoral and cellular immunity[15]. Rifampicin is lipophilic, allowing it to cross the blood–brain barrier, which suggests that CNS infections such as meningitis could be treated via systemic administration of the drug[16]. Rifampicin is a well-established immunosuppressor for psoriasis, a T-cell mediated disease[17]. Ongoing trials are evaluating rifampicin as a potential immunomodulator in the treatment of carpal tunnel syndrome[18]. Recent studies found that rifampicin remarkably attenuates the clinical signs and loss of body weight that are associated with suppression of inflammatory infiltration and demyelination in the spinal cords of experimental autoimmune encephalomyelitis (EAE) model mice[19]. Rifampicin pretreatment also attenuates status epilepticus (SE)-induced neuroinflammation and decreases the hippocampal expression of IL-1β and TNF-α. [20]
Antimicrobial resistance in Clostridium difficile ribotype 017
Published in Expert Review of Anti-infective Therapy, 2020
Korakrit Imwattana, Daniel R. Knight, Brian Kullin, Deirdre A. Collins, Papanin Putsathit, Pattarachai Kiratisin, Thomas V. Riley
Rifampicin is one of the main agents used for the treatment of tuberculosis [89]. Patients with tuberculosis are exposed to rifampicin for at least 6 months and this exposure places selective pressure on any C. difficile that may be colonizing these patients. There have been reports of a high prevalence of C. difficile RT 017 in tuberculosis hospitals in South Africa [67,90,91]. There is also a high prevalence of tuberculosis in South-East Asia [92]. This and rifampicin usage may be impacting rifaximin resistance among C. difficile RT 017 and compromising the possible use of rifaximin for the treatment of CDI due to C. difficile RT 017. An example has been reported in Staphylococcus aureus, where a rifampicin-resistant subpopulation of colonizing bacteria proliferated within only 2 weeks of the initiation of antituberculous therapy [93].
Rifampicin in periprosthetic joint infections: where do we stand and where are we headed?
Published in Expert Review of Anti-infective Therapy, 2023
Marjan Wouthuyzen-Bakker, Henk Scheper
In 1957, a Milan research group led by Piero Sensi isolated a new class of antibiotics from the bacterium Streptomyces mediterranei from a French soil sample. This new antibiotic class was named rifamycins, after the then quite popular French gangster movie Rififi (which is a French word for: ‘trouble’). The abbreviation of the active ingredient (N-Amino-N′-MethylPiperazine) completed the name. The first rifamycin for clinical use, rifamycin SV, was replaced by rifampicin because of better bioavailability and efficacy, especially against Mycobacterium tuberculosis. Rifampicin inhibits bacterial RNA synthesis by binding to the β-subunit of the DNA-dependent RNA polymerase. Rifampicin appeared to be effective against Gram-positive and some Gram-negative bacteria also, and has demonstrated bactericidal activity against intracellular microorganisms [8]. However, its effectiveness against tuberculosis has led to a strong lobby of many physicians to discourage the use of rifampicin for non-tuberculous infections due to fear of increasing resistance. This resistance is known to occur if rifampicin is used as monotherapy or when treating infections with a very high bacterial load [9]. In 1980, Acocella et al. reported that the incidence of rifampicin-resistant tuberculosis strains was not higher in countries where rifampicin was frequently used in comparison with countries with a restrictive use of rifampicin and therefore concluded that this fear was unjustified [10]. Nowadays, it is a common antibiotic prescribed for foreign body-material-related infections, including PJI.
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