rifampin and Central-Nervous-System-Diseases

Efavirenz (EFV) and rifampicin-isoniazid (RH) are cornerstone drugs in human immunodeficiency virus (HIV)-tuberculosis (TB) coinfection treatment but with complex drug interactions, efficacy and safety challenges. We reviewed recent data on EFV and RH interaction in TB/HIV high-burden countries.. We conducted a systematic review of studies conducted in the high TB/HIV-burden countries between 1990 and 2016 on EFV pharmacokinetics during RH coadministration in coinfected patients. Two reviewers conducted article screening and data collection.. Anti-TB drug coadministration minimally affect the EFV exposure, efficacy and safety among TB-HIV coinfected African and Asian patients. This supports the current 600 mg EFV dosing when coadministered with anti-TB drugs.

Topics: Africa; Anti-HIV Agents; Antitubercular Agents; Asia; Body Weight; Central Nervous System Diseases; Chemical and Drug Induced Liver Injury; Coinfection; Cost of Illness; Cytochrome P-450 CYP2B6; Drug Interactions; Female; HIV Infections; Humans; Isoniazid; Latin America; Male; Polymorphism, Single Nucleotide; Rifampin; Sex Factors; Treatment Outcome; Tuberculosis

To review the published clinical data assessing the role of adjunctive rifampin therapy for the treatment of staphylococcal central nervous system (CNS) infections.. A MEDLINE search (January 1966-March 2000) of English-language literature pertaining to CNS staphylococcal infections and rifampin was performed; tertiary sources were also used.. Human data and case reports were included, as no clinical trials have been published.. Retrospective reviews of rifampin used in combination with other antibiotics for serious bacterial infections show conflicting results. Few case reports have described clinical successes with adjunctive rifampin therapy for CNS infections.. The routine use of adjunctive rifampin for CNS infections cannot be justified.

Topics: Antibiotics, Antitubercular; Central Nervous System Diseases; Humans; Retrospective Studies; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome

There is an ever-expanding number of antimicrobial agents available for the clinician to use to combat infections. We review the majority of such agents that are currently available relative to their theoretical or proven efficacy in the treatment of CNS infections. Due to the unique ability of the CNS to exclude many agents delivered via the blood stream, easily administered and efficacious therapy remains a problem. Based on the pharmacokinetics of anti-infective drugs and their antimicrobial spectrum, at present a penicillin derivative or chloramphenicol should be used whenever possible because parenteral therapy will usually achieve the desired results. In many neurosurgery-associated infections, intrathecal or intraventricular antibiotics may be required to supplement parenteral treatment and/or surgical intervention. Some of the more promising agents (such as rifampin, trimethoprim-sulfamethoxazole, and metronidazole) await further clinical trials to establish their place in the therapeutic armamentarium. Careful, randomized, prospective studies of prophylactic antibiotics must be performed in the neurosurgical setting. A group of tables are included that summarize the expected spinal fluid levels, the sensitivities of organisms commonly causing neurosurgical infections, doses of drugs given intrathecally or intraventricularly, and recommended regimens for certain infections.

Topics: Abscess; Anti-Bacterial Agents; Anti-Infective Agents; Central Nervous System Diseases; Cephalosporins; Cephamycins; Chloramphenicol; Erythromycin; Humans; Infections; Lincomycin; Meningitis; Metronidazole; Penicillins; Polymyxins; Rifampin; Sulfonamides; Tetracyclines; Trimethoprim; Vancomycin

It has been suggested that Chlamydia pneumoniae (C. pneumoniae) is involved in the pathogenesis of diverse diseases of the central nervous system (CNS), including multiple sclerosis. We report the case of a 12-year-old male with isolated recurrent optic neuritis and an associated CNS infection with C. pneumoniae. The patient presented with three attacks of optic neuritis within 5 months. A positive polymerase chain reaction for C. pneumoniae in the cerebrospinal fluid led to the diagnosis of a CNS infection with C. pneumoniae. After treatment with the antibiotic rifampicin, he experienced no further attacks during the follow-up period of 6 years. These findings suggest the possibility of a C. pneumoniae infection as a contributing factor or even causative event for the development of optic neuritis.

Topics: Antibiotics, Antitubercular; Central Nervous System Diseases; Child; Chlamydophila Infections; Chlamydophila pneumoniae; Humans; Male; Optic Neuritis; Rifampin; Treatment Outcome

Three children had staphylococcal infections of the CNS. In two cases the organisms were resistant to methicillin sodium. Each case was treated with a combination of vancomycin hydrochloride and rifampin; in one instance vancomycin alone had been unsuccessful. The addition of rifampin resulted in prompt clinical and bacteriologic resolution. Satisfactory levels of rifampin were achieved by administering the drug either orally or intravenously, and in one patient oral administration of rifampin produced assayed levels in subdural pus many times that required for minimal bactericidal activity. Combination therapy with vancomycin and rifampin is recommended for staphylococcal infections of the CNS.

Topics: Adolescent; Brain Diseases; Cellulitis; Central Nervous System Diseases; Drug Therapy, Combination; Empyema, Subdural; Female; Humans; Infant; Male; Meningitis; Orbital Diseases; Rifampin; Staphylococcal Infections; Vancomycin

Topics: Adult; Antibody Formation; Central Nervous System Diseases; Clofazimine; Dapsone; Diagnosis, Differential; Female; Humans; Leprosy; Male; Motor Neurons; Neurologic Manifestations; Neuromuscular Diseases; Peripheral Nervous System Diseases; Rifampin

Topics: Adult; Aminosalicylic Acid; Antitubercular Agents; Central Nervous System Diseases; Chemical and Drug Induced Liver Injury; Child; Drug Interactions; Ethambutol; Female; Humans; Immunosuppression Therapy; Isoniazid; Optic Neuritis; Phenytoin; Pregnancy; Rifampin; Streptomycin; Thrombocytopenia

Topics: Adolescent; Adult; Bone Diseases; Central Nervous System Diseases; Female; Humans; Injections, Spinal; Male; Middle Aged; Neurosurgery; Pneumococcal Infections; Rifampin; Skin Diseases; Staphylococcal Infections