rifampin and morphazinamide

Multiple drug allergy (MDA) is characterized by hypersensitivity to 2 or more chemically unrelated drugs. Multiple drug allergy from simultaneous use of antituberculosis drugs is a rare phenomenon that mainly presents as an urticarial or maculopapular eruption. This case report describes a 58-year-old man who developed a generalized eczematous eruption during the sixth week of oral therapy with 4 antituberculosis drugs-isoniazid, ethambutol, rifampicin, and morphazinamide-for treatment of suspected pleural tuberculosis. The eruption resolved after treatment with systemic corticosteroids and cessation of isoniazid and ethambutol. During a lesion-free period 6 months after cessation of the corticosteroids, patch testing with serial dilutions of isoniazid and ethambutol revealed positive reactions; irritant patch test reactions were excluded by testing with graded concentrations of each drug. The patient avoided the causative drugs and reported no new eruptions at 1-year follow-up. It is important for dermatologists to consider the value of patch testing in determining the causative drugs in suspected cases of eczematous-type MDA.

Topics: Antitubercular Agents; Drug Eruptions; Drug Therapy, Combination; Eczema; Ethambutol; Follow-Up Studies; Humans; Isoniazid; Male; Middle Aged; Patch Tests; Pyrazines; Rifampin

In this report, a 27 years old male patient diagnosed to have skin and bone tuberculosis (TB) has been presented. The patient admitted to the hospital with the complaints of fever, weight loss and night sweats. Patient's history revealed that following a trauma a skin lesion in the right ankle was developed and this was followed by the development of many lesions in different parts of the body. The lesions persisted despite the use of various antibiotics since a year. It has been recorded that his father has already been receiving anti-tuberculosis treatment. Osteomyelitis was detected in the distal part of right tibia by computerized tomography, and Mycobacterium tuberculosis was isolated from the specimens of skin lesion. The patient was immunocompetent, and there was no pulmonary involvement. Isoniazid (INAH), rifampin (RIF), ethambutol and morphozinamid therapy has been started and completed to 12 months with INAH and RIF. In the post-treatment follow-up of patient for one year, no relapse was detected. As a result, tuberculosis should be considered in patients with persistent skin lesions especially in endemic countries.

Topics: Adult; Antitubercular Agents; Drug Therapy, Combination; Humans; Immunocompetence; Isoniazid; Male; Osteomyelitis; Pyrazines; Rifampin; Tibia; Tomography, X-Ray Computed; Tuberculosis, Cutaneous; Tuberculosis, Osteoarticular

Author debates the advantages of home treatment of tuberculosis and the question limits. These limits are essentially represented by a low compliance in many patients. At our Institute, we put in practice an home therapy trial of pulmonary and extra-pulmonary tuberculosis. Our treatment programme includes short-course chemotherapy (six or eight months of therapy) with rifampin, isoniazid and ethambutol associated or, instead of ethambutol, with morphazynamide. In 1982, 674 patients were treated according to this schedule. Previously we made a controlled clinical trial comparing home and hospital treatment of pulmonary tuberculosis in 50 patients newly diagnosed. The results of this study showed that both groups of patients entirely recovered at the same time. At last, Author points out that today politicians poorly know the importance of a therapeutic home programme.

Topics: Adaptation, Psychological; Ambulatory Care; Drug Administration Schedule; Humans; Kidney Diseases; Pyrazines; Rifampin; Socioeconomic Factors; Tuberculosis