rifampin and Chronic-Disease

Topics: Aged; Atrophy; Biopsy; Chronic Disease; Clofazimine; Dapsone; Drug Therapy, Combination; Eye Infections, Bacterial; Humans; Iris; Leprostatic Agents; Leprosy, Lepromatous; Macular Edema; Male; Mycobacterium leprae; Rifampin; Skin; Tomography, Optical Coherence; Uveitis, Anterior

Hepatic itch remains among the most agonizing symptoms for affected patients and a major clinical challenge for physicians. Pruritus may occur in almost all liver diseases, particularly those with cholestatic features. Hepatic itch arises irrespective of the severity of the underlying liver disease or extent of cholestasis. Antihistamines are ineffective in hepatic itch. Therapeutic recommendations consist of a guideline-based stepwise approach, starting with the anion exchange resin cholestyramine, followed by rifampicin, naltrexone, and sertraline. Bezafibrate and ileal bile acid transporter inhibitors are promising future treatment options. Experimental and invasive procedures should be reserved for refractory pruritus.

Topics: Analgesics, Opioid; Anion Exchange Resins; Antipruritics; Bezafibrate; Carrier Proteins; Cholagogues and Choleretics; Cholestasis; Cholestyramine Resin; Chronic Disease; Cytochrome P-450 Enzyme Inducers; Drainage; Humans; Hypolipidemic Agents; Membrane Glycoproteins; Methylamines; Narcotic Antagonists; Prevalence; Pruritus; Rifampin; Thiazepines; Ursodeoxycholic Acid

Pruritus is a disabling symptom accompanying chronic cholestasis. In some cases, refractory pruritus may require invasive therapies including liver transplantation. The pathogenesis of pruritus in cholestatic disease is poorly understood. It may involve a specific neural pathway and several pruritogenic substances such as bile acids, opioids, serotonin, and the more recently identified lysophosphatidic acid. While the therapeutic management of cholestatic pruritus is well established in adult patients, there is no consensus in children, given the difficulty in conducting controlled clinical studies. The currently recommended strategy to manage cholestatic pruritus in children is based on several lines of therapy that should always be associated with local cutaneous care and with nonspecific treatment of cholestasis including ursodeoxycholic acid therapy. Pruritus should be assessed as objectively as possible between each therapeutic step. Rifampicin, an enzyme inducer, is the specific first-line treatment of cholestatic pruritus. The second-line therapies require evaluation of the child in an expert center and are discussed on a case-by-case basis depending on the underlying disease, the experience of the center and the will of the child and his family. It could be inhibitors of serotonin reuptake (sertraline) or an opioid antagonist (naloxone). Invasive therapies such as biliary diversion or liver transplantation can also be proposed in the most severe cases.

Topics: Anion Exchange Resins; Biliary Tract Surgical Procedures; Child; Cholagogues and Choleretics; Cholestasis; Cholestyramine Resin; Chronic Disease; Cytochrome P-450 CYP3A Inducers; Humans; Liver Transplantation; Narcotic Antagonists; Pruritus; Rifampin; Selective Serotonin Reuptake Inhibitors; Sertraline; Sorption Detoxification; Ursodeoxycholic Acid

Fusidic acid is an oral antistaphylococcal antibiotic that has been used in Europe for more than 40 years to treat skin infections as well as chronic bone and joint infections. It is a steroidal antibiotic and the only marketed member of the fusidane class. Fusidic acid inhibits protein synthesis by binding EF-G-GDP, which results in the inhibition of both peptide translocation and ribosome disassembly. It has a novel structure and novel mode of action and, therefore, there is little cross-resistance with other known antibiotics. Many mutations can occur in the FusA gene that codes for EF-G, and some of these mutations can result in high-level resistance (minimum inhibitory concentration [MIC] > 64 mg/L), whereas others result in biologically unfit staphylococci that require compensatory mutations to survive. Low-level resistance (<8 mg/L) is more common and is mediated by fusB, fusC, and fusD genes that code for small proteins that protect EF-G-GDP from binding fusidic acid. The genes for these proteins are spread by plasmids and can be selected mostly by topical antibiotic use. Reports of resistance have led to combination use of fusidic acid with rifampin, which is superseded by the development of a new dosing regimen for fusidic acid that can be used in monotherapy. It consists of a front-loading dose to decrease the potential for resistance development followed by a maintenance dose. This dosing regimen is now being used in clinical trials in the United States for skin and refractory bone and joint infections.

Topics: Acute Disease; Administration, Oral; Anti-Bacterial Agents; Chronic Disease; Drug Resistance, Bacterial; Drug Therapy, Combination; Fusidic Acid; Humans; Microbial Sensitivity Tests; Peptide Elongation Factor G; Protein Synthesis Inhibitors; Rifampin; Staphylococcal Infections

The increasing number of prosthesis implantations and higher life expectancy lead to a growing number of periprosthetic infections (PPI). Optimal therapy necessitates interdisciplinary coordination of surgical and antimicrobial treatment. Challenges in the treatment are the increased occurrence of resistant pathogens, selection of adequate antimicrobial and surgical treatment strategies, inappropriate pretreatment and comorbidities of patients. Current treatment concepts lead to a high success rate in terms of infection eradication, when correctly applied. The individual expectations and underlying conditions of each patient must be considered when determining the therapy concept. The first step is to distinguish between acute and chronic infections. In acute infections the prosthesis can be retained but chronic infections necessitate a complete exchange of the prosthesis. Complicating factors, such as compromising soft tissue and bone conditions, osteomyelitis and infections caused by difficult-to-treat bacteria should, however, always be treated by a complete exchange of the prosthesis, even for acute infections. The antimicrobial treatment must be tailored to the causative agent, the surgical strategy as well as comorbidities and drug intolerances of the patient. It is important to distinguish between biofilm-active eradication therapy with rifampicin for gram-positive pathogens and quinolones for gram-negative organisms and suppression therapy. This article gives a structured presentation of the therapy algorithm.

Topics: Algorithms; Biofilms; Chronic Disease; Combined Modality Therapy; Debridement; Gentamicins; Humans; Joint Prosthesis; Prosthesis-Related Infections; Reoperation; Rifampin; Staphylococcal Infections; Surgical Wound Infection

To determine the safety and efficacy of rifampin for treatment of pruritus associated with cholestasis due to chronic liver disease.. Medical literature was searched systematically using keywords as rifampicin, rifampin, rifamycin, cholestasis, pruritus, itching, and liver disease. Trials that compared the efficacy of rifampin with placebo/alternative for treatment of pruritus due to chronic cholestasis were selected for analysis. Primary outcomes were resolution of pruritus and development of side effects. Association was measured with the odds ratio (OR). Breslow-Day method was used to treat for homogeneity under null hypothesis that OR was consistent across all the trials. Corrected Mantel-Haenszel chi(2) test was used to test if OR differed systematically from value of 1.. Five prospective randomized-controlled cross-over trials with 61 patients were identified. Treatment with rifampin led to complete or partial resolution of pruritus in 47 (77%) patients as compared with 12(20%) treated with placebo or alternative (OR 15.2, 95% confidence interval 5.2-45.6, P=0.001). Four (7%) patients treated with rifampin suffered side effects, which resolved after its discontinuation. There was no incidence of hepatotoxicity. Test of heterogeneity for primary end points among the trials was not significant (P=0.16).. This meta-analysis suggests that rifampin is safe and effective for treatment of pruritus due to chronic cholestasis. This analysis also suggests that use of rifampin for short duration is associated with a low risk of hepatotoxicity.

Topics: Cholestasis; Chronic Disease; Cross-Over Studies; Humans; Prospective Studies; Pruritus; Rifampin

Topics: Anti-Bacterial Agents; Chronic Disease; Coxiella burnetii; Diagnosis, Differential; Drug Therapy, Combination; Humans; Prognosis; Q Fever; Rifampin; Tetracyclines

We report a case of Mycobacterium marinum facial sporotrichoid infection in an otherwise healthy 2-year-old child, probably acquired through contact with pets in an aquarium. The M. marinum isolate was susceptible to clarithromycin, and the child was successfully treated with oral antibiotic therapy. This unusual case emphasizes the importance of a thorough history in the evaluation of a patient with chronic sporotrichoid skin lesions.

Topics: Administration, Oral; Anti-Bacterial Agents; Child, Preschool; Chronic Disease; Clarithromycin; Diagnosis, Differential; Drug Therapy, Combination; Facial Dermatoses; Humans; Male; Mycobacterium Infections, Nontuberculous; Rifampin; Sporotrichosis

The current practice of using INH for tuberculosis prevention is limited by the necessity for at least 6 months of therapy and the problem of INH-induced hepatitis, particularly in older individuals and those with chronic liver disease. Bacteriologic models suggest that, in their persistent form, tubercle bacilli are relatively resistant to INH but become more sensitive to other drugs. Similarly, animal models of latent tuberculosis have suggested that alternative, short-course combinations such as RIF/PZA may be effective, and clinical trials of that two-drug regimen are continuing. At the present time, 3 months of daily RIF, 2 months of RIF/PZA, and 3 months of rifabutin can be considered reasonable alternatives to INH in selected patients. Routine use of these agents in preference to INH cannot yet be endorsed, however, as the standard of care. Without highly effective vaccines for tuberculosis, an important strategy for breaking the cycle of tuberculosis transmission lies in inexpensive, convenient, and effective preventive therapy.

Topics: Animals; Anti-Bacterial Agents; Antibiotic Prophylaxis; Antitubercular Agents; Chronic Disease; Clinical Trials as Topic; Disease Models, Animal; Drug Therapy, Combination; Humans; Isoniazid; Mice; Mycobacterium tuberculosis; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Administration, Oral; Anti-Bacterial Agents; Anti-Infective Agents; Chronic Disease; Drug Therapy, Combination; Fluoroquinolones; Gram-Negative Bacterial Infections; Humans; Osteomyelitis; Rifampin; Staphylococcal Infections; Trimethoprim, Sulfamethoxazole Drug Combination

A case is reported of hemolytic anemia following rifampicin administration and complicated by acute renal failure. Furthermore clotting analyses suggested a slight disseminated intravascular coagulation, very likely activated by hemolysis products. Both hemolysis and renal function impairment subsided spontaneously, after the sole withdrawal of rifampin. Direct antiglobulin test became negative within a few days, while an indirect Coomb's test was demonstrated persistently with the patient's serum using red blood cells sensitized in vitro with the drug. Otherwise from all reports in the literature, the patient developed an acute hemolytic anemia while on daily therapy and as many as twenty years after a previous treatment with rifampicin. Mechanisms of drug-induced immune hemolytic anemia and acute nephropathy are discussed (formation of drug-antibody complexes, which adhere on the red blood cells surface and are able to fix complement and induce intravascular hemolysis; tubular necrosis due to hemoglobinuria or immuno-mediated interstitial nephritis).

Topics: Acute Kidney Injury; Anemia, Hemolytic, Autoimmune; Bronchitis; Chronic Disease; Drug Therapy, Combination; Female; Humans; Middle Aged; Rifampin; Time Factors

The author reviews the recent advances in the treatment of Mediterranean Spotted Fever and Q fever. In mediterranean spotted fever (M.S.F.), in vitro and preliminary in vivo data support the place of quinolones and josamycin in the treatment of M.S.F. In children josamycin could become the first choice drug as well as in pregnant woman. In Q fever chronic disease should be treated using a combination of antibiotic (doxycycline + quinolones) for a minimum of 3 years.

Topics: 4-Quinolones; Anti-Infective Agents; Boutonneuse Fever; Chronic Disease; Coxiella; Doxycycline; Drug Therapy, Combination; Humans; Josamycin; Q Fever; Recurrence; Rickettsia Infections; Rifampin

A 64-year-old alcoholic man had a chronic cavitary pulmonary infiltrate. Initial sputum smears and cultures yielded abundant acid-fast organisms subsequently identified as Mycobacterium terrae. Treatment with rifampin and ethambutol resulted in progressive clinical and roentgenographic resolution with an apparent cure after 18 months of therapy.

Topics: Chronic Disease; Ethambutol; Humans; Klebsiella Infections; Lung Diseases; Male; Middle Aged; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Radiography; Rifampin; Time Factors

Topics: Brucella; Brucellosis; Chronic Disease; Enzyme-Linked Immunosorbent Assay; Humans; Rifampin; Serologic Tests; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: Alcoholism; Analgesics; Anesthetics; Blood Proteins; Chronic Disease; Drug Interactions; Ethanol; Hormones; Humans; Immunity; Liver Diseases; Methadone; Prolactin; Respiration; Rifampin; Serum Albumin; Substance-Related Disorders; United States

Topics: Administration, Oral; Age Factors; Anti-Bacterial Agents; Antitubercular Agents; Chronic Disease; Drug Resistance, Microbial; Drug Synergism; Drug Tolerance; Ethambutol; Fasting; Humans; Mycobacterium tuberculosis; Rifampin; Time Factors; Tuberculosis

Topics: Acute Disease; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Aerosols; Asthma; Bronchitis; Chromones; Chronic Disease; Ethambutol; Humans; Mycoplasma Infections; Respiratory Insufficiency; Respiratory Tract Diseases; Respiratory Tract Infections; Rifampin; Tuberculosis; Tuberculosis, Pulmonary; Virus Diseases

Sarcoidosis is a chronic granulomatous disease for which there are limited therapeutic options. This is the first randomized, placebo-controlled study to demonstrate that antimycobacterial therapy reduces lesion diameter and disease severity among patients with chronic cutaneous sarcoidosis.. To evaluate the safety and efficacy of once-daily antimycobacterial therapy on the resolution of chronic cutaneous sarcoidosis lesions.. A randomized, placebo-controlled, single-masked trial on 30 patients with symptomatic chronic cutaneous sarcoidosis lesions deemed to require therapeutic intervention.. A tertiary referral dermatology center in Nashville, Tennessee.. Participants were randomized to receive either the oral concomitant levofloxacin, ethambutol, azithromycin, and rifampin (CLEAR) regimen or a comparative placebo regimen for 8 weeks with a 180-day follow-up.. Participants were monitored for absolute change in lesion diameter and decrease in granuloma burden, if present, on completion of therapy.. In the intention-to-treat analysis, the CLEAR-treated group had a mean (SD) decrease in lesion diameter of -8.4 (14.0) mm compared with an increase of 0.07 (3.2) mm in the placebo-treated group (P = .05). The CLEAR group had a significant reduction in granuloma burden and experienced a mean (SD) decline of -2.9 (2.5) mm in lesion severity compared with a decline of -0.6 (2.1) mm in the placebo group (P = .02).. Antimycobacterial therapy may result in significant reductions in chronic cutaneous sarcoidosis lesion diameter compared with placebo. These observed reductions, associated with a clinically significant improvement in symptoms, were present at the 180-day follow-up period. Transcriptome analysis of sarcoidosis CD4+ T cells revealed reversal of pathways associated with disease severity and enhanced T-cell function following T-cell receptor stimulation.. clinicaltrials.gov Identifier: NCT01074554.

Topics: Administration, Oral; Adult; Aged; Anti-Bacterial Agents; Azithromycin; CD4-Positive T-Lymphocytes; Chronic Disease; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Humans; Levofloxacin; Male; Middle Aged; Ofloxacin; Rifampin; Sarcoidosis; Severity of Illness Index; Single-Blind Method; Skin Diseases; Transcriptome; Treatment Outcome; Young Adult

Chlamydia trachomatis and Chlamydophila (Chlamydia) pneumoniae are known triggers of reactive arthritis (ReA) and exist in a persistent metabolically active infection state in the synovium, suggesting that they may be susceptible to antimicrobial agents. The goal of this study was to investigate whether a 6-month course of combination antibiotics is an effective treatment for patients with chronic Chlamydia-induced ReA.. This study was a 9-month, prospective, double-blind, triple-placebo trial assessing a 6-month course of combination antibiotics as a treatment for Chlamydia-induced ReA. Eligible patients had to be positive for C trachomatis or C pneumoniae by polymerase chain reaction (PCR). Groups received 1) doxycycline and rifampin plus placebo instead of azithromycin; 2) azithromycin and rifampin plus placebo instead of doxycycline; or 3) placebos instead of azithromycin, doxycycline, and rifampin. The primary end point was the number of patients who improved by 20% or more in at least 4 of 6 variables without worsening in any 1 variable in both combination antibiotic groups combined and in the placebo group at month 6 compared with baseline.. The primary end point was achieved in 17 of 27 patients (63%) receiving combination antibiotics and in 3 of 15 patients (20%) receiving placebo. Secondary efficacy end points showed similar results. Six of 27 patients (22%) randomized to combination antibiotics believed that their disease went into complete remission during the trial, whereas no patient in the placebo arm achieved remission. Significantly more patients in the active treatment group became negative for C trachomatis or C pneumoniae by PCR at month 6. Adverse events were mild, with no significant differences between the groups.. These data suggest that a 6-month course of combination antibiotics is an effective treatment for chronic Chlamydia-induced ReA.

Topics: Adult; Aged; Anti-Bacterial Agents; Antibiotics, Antitubercular; Arthritis, Reactive; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Chlamydophila pneumoniae; Chronic Disease; DNA, Bacterial; Double-Blind Method; Doxycycline; Drug Therapy, Combination; Female; Humans; Joints; Male; Middle Aged; Placebos; Prohibitins; Prospective Studies; Rifampin; Treatment Outcome

Both linezolid and cotrimoxazole are antibiotics that are well suited for oral therapy of bone and joint infections (BJI) caused by otherwise resistant Gram-positive cocci (GPC) (resistance to fluoroquinolones, maccolides, betalactamines). However, in this context, no data are currently available regarding the safety and tolerance of these antibiotics in combination with rifampicin. The objective of this study was to compare the efficacy and safety of a combination of rifampicin and linezolid (RLC) with those of a combination of rifampicin and cotrimoxazole (RCC) in the treatment of BJI. Between February 2002 and December 2006, 56 adult patients (RLC, n = 28; RCC, n = 28), including 36 with infected orthopaedic devices (RLC, n = 18; RCC, n = 18) and 20 with chronic osteomyelitis (RLC, n = 10; RCC, n = 10), were found to be eligible for inclusion in this study. Patients who discontinued antibiotic therapy within 4 weeks of commencing treatment were considered to represent cases of treatment failure and were excluded. Rates of occurrence of adverse effects were similar in the two groups, at 42.9% in the RLC group and 46.4% in the RCC group (p = 1.00), and led to treatment discontinuation in four (14.3%) RLC and six (21.4%) RCC patients. Cure rates were found to be similar in the two groups (RLC, 89.3%, RCC, 78.6%; p = 0.47). Prolonged oral RLC and RCC therapy were found to be equally effective in treating patients with BJI caused by resistant GPC, including patients with infected orthopaedic devices. However, the lower cost of cotrimoxazole compared with linezolid renders RCC an attractive treatment alternative to RLC. Further larger clinical studies are warranted to confirm these preliminary results.

Topics: Acetamides; Administration, Oral; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Chronic Disease; Drug Therapy, Combination; Female; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Linezolid; Male; Middle Aged; Orthotic Devices; Osteomyelitis; Oxazolidinones; Prosthesis-Related Infections; Rifampin; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

To determine the safety and efficacy of rifampin for treatment of pruritus associated with cholestasis due to chronic liver disease.. Medical literature was searched systematically using keywords as rifampicin, rifampin, rifamycin, cholestasis, pruritus, itching, and liver disease. Trials that compared the efficacy of rifampin with placebo/alternative for treatment of pruritus due to chronic cholestasis were selected for analysis. Primary outcomes were resolution of pruritus and development of side effects. Association was measured with the odds ratio (OR). Breslow-Day method was used to treat for homogeneity under null hypothesis that OR was consistent across all the trials. Corrected Mantel-Haenszel chi(2) test was used to test if OR differed systematically from value of 1.. Five prospective randomized-controlled cross-over trials with 61 patients were identified. Treatment with rifampin led to complete or partial resolution of pruritus in 47 (77%) patients as compared with 12(20%) treated with placebo or alternative (OR 15.2, 95% confidence interval 5.2-45.6, P=0.001). Four (7%) patients treated with rifampin suffered side effects, which resolved after its discontinuation. There was no incidence of hepatotoxicity. Test of heterogeneity for primary end points among the trials was not significant (P=0.16).. This meta-analysis suggests that rifampin is safe and effective for treatment of pruritus due to chronic cholestasis. This analysis also suggests that use of rifampin for short duration is associated with a low risk of hepatotoxicity.

Topics: Cholestasis; Chronic Disease; Cross-Over Studies; Humans; Prospective Studies; Pruritus; Rifampin

To determine the clinical role of rifampin containing antibiotic combination and modified two-stage exchange arthroplasty with a vancomycin loaded polymethylmethacrylate (PMMA) spacer for the treatment of orthopaedic implant related Staphylococcus epidermidis infections, a prospective study was initiated. A total of 10 patients, with a mean age of 59 years (range: 32 to 78 years) were included in the study. The mean follow up was 23.4 months (range: 16 to 36 months). Six patients had an infected hemiarthroplasty of the hip, three had infected total hip arthroplasty, and one had an infected femoral neck fracture with implant failure and pseudoarthrosis. All had culture-proven Staphylococcus epidermidis infections, six of the isolates were methicillin resistant. Following debridement and implantation of a PMMA spacer, a rifampin-vancomycin antibiotic protocol was initiated until the erythrocyte sedimentation rate and C-reactive protein levels were within normal limits. After reimplantation and discharge from the hospital, oral antibiotics with rifampin-ciprofloxacin were continued for three to six months. At the final follow-up none of the patients had any clinical or laboratory signs of infection. Although this study includes a limited number of patients and relatively short-term follow-up the results indicate that in the presence of orthopaedic implant infection with Staphylococcus epidermidis, modified two-stage exchange arthroplasty using a vancomycin-loaded PMMA spacer and a rifampin-containing antibiotic protocol may be beneficial.

Topics: Adult; Aged; Anti-Bacterial Agents; Arthroplasty, Replacement, Hip; Chronic Disease; Female; Follow-Up Studies; Hip Prosthesis; Humans; Male; Middle Aged; Prospective Studies; Prosthesis-Related Infections; Reoperation; Rifampin; Staphylococcal Infections; Staphylococcus epidermidis; Treatment Outcome; Vancomycin

Rifampin has been proposed to reduce pruritus in children and adults with chronic cholestasis; however, there is a paucity of published data regarding the use of rifampin in children.. In an open trial, 24 children were evaluated during a 6-year period. Diagnoses included 13 patients with extrahepatic biliary atresia (54%), six with Alagille's syndrome, three with Byler's disease, and one each with primary sclerosing cholangitis and alpha1-antitrypsin deficiency. All patients had severe pruritus that had not responded adequately to at least 2 months of therapy with ursodeoxycholic acid, diphenhydramine, or phenobarbital and local skin care measures. Treatment was initiated with rifampin, 10 mg/kg per day in two divided doses for 18+/-20 months, and the effect on the severity of pruritus was assessed by a clinical scoring system.. Ten patients showed a complete response, 12 a partial response, and 2 no response. Complete response was more common in extrahepatic cholestasis (64% vs. 10%), whereas partial response was more common in intrahepatic cholestasis (80% vs. 29%). Treatment was associated with reduction of gamma-glutamyl transpeptidase. No clinical or biochemical toxicity of rifampin was observed.. We conclude that for more than 90% of children with chronic cholestasis and severe pruritus unresponsive to other treatments, rifampin appears to be a safe and effective therapy.

Topics: Adolescent; Child; Child, Preschool; Cholestasis; Chronic Disease; Female; Humans; Infant; Male; Pruritus; Rifampin; Treatment Outcome

A study of rifabutin in the retreatment of patients with chronic pulmonary tuberculosis whose strains of tubercle bacilli were resistant to all three of the drugs isoniazid, streptomycin, and rifampicin, and usually to others as well, was undertaken in 22 Chinese patients in Hong Kong. They were arranged in 11 pairs such that the resistance pattern of the strains for both patients was the same or closely similar. One of each pair was allocated at random to receive rifabutin (B) daily and the other rifampicin (R) daily. The two members of each pair were also prescribed the same or similar companion drugs, selected on the basis of the results of susceptibility tests and of the history of previous antituberculosis chemotherapy. The bacteriological results showed no evidence of a sustained benefit in any patient. A temporary response was seen on sputum smear examination in 14 patients (7B, 7R), of whom 10 (5B, 5R) had a period of smear-negativity, and on sputum culture examination in 10 patients (5B, 5R), of whom 3 (2B, 1R) had a period of culture-negativity. The duration of response was longer for the B patient in 5 pairs and for the R patient in 5. Two patients (both B) had rifabutin-susceptible strains on admission to the study; their temporary responses were among the best and were associated with the emergence of rifabutin resistance, suggesting that rifabutin may have contributed to their response. A total of 17 patients, including 7 not in the paired comparison, were subsequently retreated with ofloxacin; 10 showed a response, disease becoming and remaining quiescent in 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Antitubercular Agents; Chronic Disease; Dose-Response Relationship, Drug; Drug Resistance, Microbial; Drug Therapy, Combination; Female; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Ofloxacin; Rifabutin; Rifampin; Rifamycins; Sputum; Streptomycin; Treatment Outcome; Tuberculosis, Pulmonary

We previously demonstrated that chronic pharyngeal carriage of group A beta-hemolytic streptococci (GABHS) can be terminated by intramuscular administration of benzathine penicillin plus 4 days of orally administered rifampin. Because an effective oral regimen would be desirable, we compared clindamycin with P + R for treating GABHS carriage. Healthy, symptom-free GABHS carriers were randomly assigned to receive orally administered clindamycin (20 mg/kg per day) three times a day for 10 days or intramuscularly administered benzathine penicillin with oral doses of rifampin (20 mg/kg per day) twice a day for 4 days. Compliance was documented by antibiotic activity in urine. Throat cultures for GABHS were obtained every 3 weeks for up to 9 weeks after treatment. Patients who had positive throat cultures for their original GABHS T type 3 weeks after randomization were crossed over to the other treatment. Treatment success was defined as eradication of the original GABHS T type, with all follow-up cultures negative. Clindamycin eradicated carriage in 24 (92%) of 26 patients; penicillin plus rifampin was effective in 12 (55%) of 22 patients (p less than 0.025). Including patients crossed over 3 weeks after enrollment, clindamycin was effective in 28 (85%) of 33 treatment courses compared with 12 of 22 courses of penicillin plus rifampin (p less than 0.05). We conclude that 10 days of oral clindamycin therapy was significantly more effective than benzathine penicillin plus 4 days of orally administered rifampin for treatment of symptom-free GABHS carriers.

Topics: Administration, Oral; Adolescent; Carrier State; Child; Child, Preschool; Chronic Disease; Clindamycin; Drug Evaluation; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Injections, Intramuscular; Male; Microbial Sensitivity Tests; Penicillin G Benzathine; Pharyngitis; Rifampin; Streptococcal Infections; Streptococcus pyogenes

Chronic cholestatic liver disease in children frequently results in severe intractable pruritus. Current forms of therapy, including cholestyramine, are usually ineffective. Therefore, a 6-wk, double-blind, crossover study was designed to test the ability of rifampin to relieve pruritus in children with chronic cholestasis. Rifampin proved effective in alleviating pruritus in all five children tested compared with a placebo-treated group. After the 6-wk study period, rifampin was continued for 6 mo, and its effectiveness was maintained. No complications resulted from rifampin use. This study and a similar study in older patients with primary biliary cirrhosis suggest that a highly effective form of therapy is available for treatment of severe pruritus in patients with chronic cholestasis. These patients must be carefully selected and frequently monitored.

Topics: Adolescent; Child; Cholestasis, Intrahepatic; Chronic Disease; Double-Blind Method; Humans; Pruritus; Randomized Controlled Trials as Topic; Rifampin

We investigated the effect of rifampin on pruritus in 12 patients with chronic liver disease: non-A, non-B hepatitis (n = 3), alcoholic cirrhosis (n = 4), primary biliary cirrhosis (n = 4), and primary sclerosing cholangitis (n = 1). The study was a crossover, randomized, double-blind trial where placebo and drug were given daily in identical capsules (300 mg) for 2 weeks each, with a 1 week washout before and after each cycle. Mean duration of pruritus was 1.6 years (range of 4 months-5 years). Blood tests were done weekly and patients used a visual analogue scale (VAS) from 0 to 100 to mark their level of itchiness daily. Only transaminases were significantly lower while the patients were on rifampin. VAS scores were minimally affected by either rifampin or placebo. At the end of the trial, four patients said they were less itchy on rifampin and three preferred placebo. Of these seven patients, small falls in VAS scores occurred in two patients on rifampin and two on placebo; there was no change in the remaining three. There was little change in serum bile salt levels during the trial. No patient became jaundiced and deepening of jaundice did not occur in the four patients with initially elevated bilirubin. We conclude that a daily 300 mg dose of rifampin was not effective in relieving pruritus in a variety of chronic liver diseases.

Topics: Adult; Aged; Chronic Disease; Double-Blind Method; Female; Humans; Liver Diseases; Male; Middle Aged; Monitoring, Physiologic; Pruritus; Randomized Controlled Trials as Topic; Rifampin

A controlled trial of treatment of chronic osteomyelitis caused by Staphylococcus aureus compared nafcillin alone with nafcillin plus rifampin for a six-week period. Treatment was well tolerated, the only adverse effect being mild neutropenia in four of 18 patients; no toxicity was observed from rifampin. Eight of ten patients in the combined treatment group had a favorable clinical response (with follow-up of two to four years) as compared to four of eight in the nafcillin group (P = .2). Despite the failure to show a statistically significant advantage of rifampin plus nafcillin, we conclude that the combination, along with appropriate surgery, should be considered for patients with chronic staphylococcal osteomyelitis.

Topics: Administration, Oral; Blood Sedimentation; Chronic Disease; Clinical Trials as Topic; Combined Modality Therapy; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nafcillin; Neutropenia; Osteomyelitis; Random Allocation; Rifampin; Staphylococcal Infections; Time Factors

A controlled clinical trial of Rifaprim (rifampicin 600 mg plus trimethoprim 160 mg, in a single daily dose at 10 p.m.) and cotrimoxazole (two tablets b.i.d.) was carried out in two groups of twenty-one patients, each with chronic or recurrent urinary tract infections. Both treatments lasted 10 days. At the first follow-up, 3-11 days after the end of treatment, bacteriological failure was observed in two Rifaprim patients and in four contrimoxazole patients. Clinical improvement with sterile urine or markedly reduced bacterial count was observed in nineteen. Rifaprim patients and in fifteen cases of the other group. Mild allergic phenomena were observed in three Rifaprim patients, but they did not require discontinuation of treatment; anorexia was complained of by a cotrimoxazole patient. Rifaprim appears a valuable alternative in the treatment of chronic urinary tract infection, mainly because it reduces or abolishes the risk of emergence of resistance.

Topics: Adult; Bacteria; Chronic Disease; Clinical Trials as Topic; Drug Combinations; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Male; Middle Aged; Rifampin; Sulfamethoxazole; Trimethoprim; Urinary Tract Infections

In patients with chronic pulmonary tuberculosis the results of chemotherapy between drug regimens containing ethambutol or rifampicin were compared. Patients in both groups were randomized selected. After 4 months of chemotherapy negativization was reached to 100% in the RMP-group compared to 80% of the patients in the EMB-group. In 98 chronics EMB was added to the chemotherapy regimen and resulted in 90% of negativization. In a small subgroup RMP was added to the regimen and 100% negativization could be obtained. Among 220 patients with chronic pulmonary tuberculosis, treated with RMP in 9 hospitals according to our protocoll, in 205 patients (93.2%) the excretion of bacilli was cessated. In 54 new cases treated with EMB and another combination and in 20 new cases treated additionally with RMP the sputum converted to negative in 100% of the patients. But the the negativization was reached 24 days earlier on the average in the group treated with RMP. Antituberculotic drugs are administered in our clinic according to the body weight.

Topics: Chronic Disease; Drug Therapy, Combination; Ethambutol; Humans; Recurrence; Rifampin; Tuberculosis, Pulmonary

The present report concerns the results at 1 year of a co-operative controlled clinical study carried out in Poland of the retreatment of patients with active, chronic, polyresistant far-advance pulmonary tuberculosis with an oral regimen of daily followed by intermittent ethambutol and rifampicin. A comparison was made of once- and twice-weekly supervised intermittent regimens of rifampicin 1200 mg plus ethambutol 50 mg/kg body weight under out-patient conditions after an initial inpatient phase of rifampicin 600 mg and ethambutol 25 mg/kg daily for 12 weeks. Patients were allocated at random to the regimens. Of 247 patients admitted to the study, 201 (81 per cent) completed 1 year's treatment as prescribed by the protocol, 46 (19 per cent) patients terminated their treatment prematurely before 1 year. After the daily phase of 12 weeks' treatment, 82 per cent were negative on smear and 85 per cent on culture; in the continuation intermittent phase, 98 per cent of patients in the once-weekly (E1R1) regimen were negative on culture at 28 weeks and 98 per cent in the twice-weekly (E2R2) regimen. The corresponding proportions at 52 weeks were 97 per cent and 97 per cent. At 12 months, 96 per cent of 101 ER/E1R1 and 96 per cent of 100 ER/E2R2 patients who completed 1 years' treatment were culture-negative.

Topics: Adolescent; Adult; Aged; Chronic Disease; Clinical Trials as Topic; Drug Administration Schedule; Drug Hypersensitivity; Drug Resistance, Microbial; Ethambutol; Female; Gastrointestinal Diseases; Humans; Male; Middle Aged; Purpura; Rifampin; Sputum; Tuberculosis, Pulmonary; Vision Disorders

Topics: Adult; Chronic Disease; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary; Yugoslavia

Topics: Chronic Disease; Clinical Trials as Topic; Ethambutol; Humans; Retrospective Studies; Rifampin; Tuberculosis, Pulmonary; Yugoslavia

Topics: Adolescent; Adult; Ampicillin; Bacteriuria; Chronic Disease; Clinical Trials as Topic; Escherichia coli Infections; Female; Humans; Klebsiella Infections; Male; Middle Aged; Placebos; Proteus Infections; Recurrence; Rifampin

The possible existence of kinetic interactions between rifampicin and isoniazid and the effect of the concomitant presence of an impaired liver function were investigated in man. In a first study normal healthy subjects and patients with chronic liver disease received, on three different occasions, a single dose of 600 mg rifampicin or isoniazid and of rifampicin and isoniazid associated in randomized sequences. The results have shown that in both groups the serum levels, half-life values, and urinary excretion of each drug given alone are not significantly different from those observed when the other drug is associated. Serum levels and half-life of rifampicin and isoniazid were significantly higher in patients with chronically impaired liver. In a second study, rifampicin and isoniazid were given in combination at the same doses as in the first study over a period of one week. The results have shown a trend to decrease in the serum levels of rifampicin of the healthy subjects and a trend to increase in the patients with chronic liver disease on day 7 of treatment. In both groups a reduction in the half-life of rifampicin was also observed. No changes in serum isoniazid concentrations were observed between day 1 and day 7 in the healthy subjects, whereas a significant increase was observed in the patients. No significant changes in the half-life of isoniazid were observed.

Topics: Adult; Bilirubin; Chronic Disease; Half-Life; Humans; Isoniazid; Kinetics; Liver Cirrhosis; Male; Rifampin; Statistics as Topic; Time Factors

Topics: Bilirubin; Chronic Disease; Clinical Trials as Topic; Drug Combinations; Drug Interactions; Humans; Isoniazid; Liver; Liver Diseases; Rifampin; Time Factors

Topics: Chronic Disease; Clinical Trials as Topic; Drug Combinations; Drug Resistance, Microbial; Ethambutol; Humans; Isoniazid; Liver; Pilot Projects; Rifampin; Sputum; Streptomycin; Time Factors; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Algeria; Chronic Disease; Clinical Trials as Topic; Drug Synergism; Ethambutol; Humans; Middle Aged; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Bacteriological Techniques; Bronchitis; Chronic Disease; Drug Resistance, Microbial; Haemophilus influenzae; Humans; Rifampin; Sputum; Streptococcus pneumoniae

Topics: Adult; Aged; Antitubercular Agents; Chronic Disease; Clinical Trials as Topic; Cycloserine; Drug Synergism; Humans; Middle Aged; Rifampin; Tuberculosis

Topics: Adult; Antitubercular Agents; Chronic Disease; Clinical Trials as Topic; Drug Synergism; Ethambutol; Female; Humans; Isonicotinic Acids; Male; Middle Aged; Rifampin; Tuberculosis

Bacteria colonising the lungs of cystic fibrosis (CF) patients encounter high selective pressures. Hypermutation facilitates adaptation to fluctuating environments, and hypermutator strains are frequently isolated from CF patients. We investigated the prevalence of hypermutator isolates of Achromobacter spp. among patients affiliated with the CF Centre in Aarhus, Denmark. By exposure to rifampicin, the mutation frequency was determined for 90 isolates of Achromobacter spp. cultured from 42 CF patients; 20 infections were categorised as chronic, 22 as intermittent. The genetic mechanisms of hypermutation were examined by comparing DNA repair gene sequences from hypermutator and normomutator isolates. Achromobacter spp. cultured from 11 patients were categorised as hypermutators, and this phenotype was exclusively associated with chronic infections. Isolates of the Danish epidemic strain (DES) of Achromobacter ruhlandii cultured from patients from both Danish CF centres showed elevated mutation frequencies. The hypermutator state of Achromobacter spp. was most commonly associated with nonsynonymous mutations in the DNA mismatch repair gene mutS; a single clone had developed a substitution in the S-adenosyl-L-methionine-dependent methyltransferase putatively involved in DNA repair mechanisms, but not previously linked to the hypermutator phenotype. Hypermutation is prevalent among clinical isolates of Achromobacter spp. and could be a key determinant for the extraordinary adaptation and persistence of DES.

Topics: Achromobacter; Anti-Bacterial Agents; Chronic Disease; Cystic Fibrosis; Denmark; DNA Mismatch Repair; Humans; Mutation; Mutation Rate; MutS DNA Mismatch-Binding Protein; Phenotype; Prevalence; Rifampin

The purpose of this study was to gather temporal trends on bacteria epidemiology and resistance of intraoperative bone culture from chronic ostemyelitis at an affiliated hospital in South China.. Records of patients with chronic osteomyelitis from 2003 to 2014 were retrospectively reviewed. The medical data were extracted using a unified protocol. Antimicrobial susceptibility testing was carried out by means of a unified protocol using the Kirby-Bauer method, results were analyzed according to Clinical and Laboratory Standards Institute definitions.. Four hundred eighteen cases met our inclusion criteria. For pathogen distribution, the top five strains were Staphylococcus aureus (27.9%); Pseudomonas aeruginosa (12.1%); Enterobacter cloacae (9.5%); Acinetobacter baumanii (9.0%) and Escherichia coli (7.8%). Bacterial culture positive rate was decreased significantly among different year-groups. Mutiple bacterial infection rate was 28.1%. One strain of Staphylococcus aureus was resistant to linezolid and vancomycin. Resistance of Pseudomonas aeruginosa stains to Cefazolin, Cefuroxime, Cefotaxime, and Cefoxitin were 100% nearly. Resistance of Acinetobacter baumanii stains against Cefazolin, Cefuroxime were 100%. Ciprofloxacin resistance among Escherichia coli isolates increased from 25 to 44.4%. On the contrary, resistance of Enterobacter cloacae stains to Cefotaxime and Ceftazidime were decreased from 83.3 to 36.4%.. From 2003 to 2014, positive rate of intraoperative bone culture of chronic osteomyelitis was decreased; the proportion of Staphylococcus aureus was decreased gradually, and our results indicate the importance of bacterial surveilance studies about chronic osteomyelitis.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Cefotaxime; China; Chronic Disease; Drug Resistance, Bacterial; Escherichia coli; Female; Hospitals; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Osteomyelitis; Pseudomonas aeruginosa; Retrospective Studies; Rifampin; Staphylococcus aureus; Young Adult

Query fever (Q fever), caused by

Topics: Adult; Aged; Anti-Bacterial Agents; California; Chronic Disease; Doxycycline; Endocarditis, Bacterial; Hospitals, Veterans; Humans; Hydroxychloroquine; Male; Middle Aged; Q Fever; Retrospective Studies; Rifampin

Topics: Adolescent; Angioedema; Biopsy; Chronic Disease; Clofazimine; Dapsone; Developing Countries; Diagnosis, Differential; Drug Therapy, Combination; Facial Dermatoses; Follow-Up Studies; Humans; India; Leprosy, Multibacillary; Male; Rifampin; Sinusitis; Skin

Topics: Biopsy; Chronic Disease; Clarithromycin; Dermis; Diagnosis, Differential; Doxycycline; Drug Therapy, Combination; Epidermis; Female; Humans; Immunocompetence; Leg Dermatoses; Lymphedema; Middle Aged; Mycobacterium Infections, Nontuberculous; Rifampin

Chronic osteomyelitis is a chronic inflammatory disease induced by bone infection. It may be limited to a single portion of bone or involve several areas such as marrow, cortical, periosteum and adjacent soft tissues. Being able to persist for weeks, months or even years, it remains a therapeutic challenge in spite of the important medical and surgical advances, with a prolonged and complex management given the nature of the surgical interventions and the antibiotherapies required. We report a case of chronic osteomyelitis treated by long-term suppressive antibiotic therapy, which may be a reasonable alternative to surgery in inoperable clinical situations, but taking into account the risks associated with it in terms of side effects and selection of resistant organisms, as well as the cost of treatment and the quality of life of the patient.. L’ostéomyélite chronique est une pathologie inflammatoire chronique induite par une infection osseuse. Elle peut être limitée à une seule portion d’os ou impliquer plusieurs zones telles que la moelle, la corticale, le périoste et les tissus mous adjacents. Pouvant persister pendant des semaines, des mois voire des années, elle reste un challenge thérapeutique en dépit des importantes avancées médicales et chirurgicales, avec une prise en charge prolongée et complexe compte tenu de la nature des interventions chirurgicales et des antibiothérapies requises. Nous rapportons un cas d’ostéomyélite chronique pris en charge par antibiothérapie suppressive au long cours, qui peut être une alternative raisonnable à la chirurgie dans des situations cliniques inopérables, mais en prenant en considération les risques qui y sont associés en termes d’effets secondaires et de sélection des germes résistants, ainsi que le coût du traitement et la qualité de vie du patient.

Topics: Aged; Anti-Bacterial Agents; Chronic Disease; Drug Administration Schedule; Floxacillin; Humans; Male; Minocycline; Osteomyelitis; Rifampin

The spleen is known as an important filter for blood-borne pathogens that are trapped by specialized macrophages in the marginal zone (MZ): the CD209

Topics: Animals; Anti-Bacterial Agents; B-Lymphocytes; Brucella abortus; Brucella melitensis; Brucella suis; Brucellosis; Chemokine CCL19; Chemokine CCL21; Chemokine CXCL13; Chronic Disease; Gene Expression Regulation; Host-Pathogen Interactions; Interferon gamma Receptor; Interferon-gamma; Macrophages; Mice; Mice, Inbred C57BL; Mice, Knockout; Receptors, Interferon; Receptors, Tumor Necrosis Factor, Type I; Rifampin; RNA, Messenger; Signal Transduction; Spleen; Streptomycin; T-Lymphocytes

To investigate the effect of oral Rifampin in patients with chronic central serous chorioretinoapthy (CSCR).. This was a prospective pilot study of patients with chronic CSCR with persistent subretinal fluid (SRF) for at least 3 months, who were treated with oral Rifampin 300 mg twice per day for 3 months and had 6 months of follow-up. All patients underwent a complete ocular examination and a spectral domain optical coherence tomography (SD-OCT) scan monthly from baseline until month 4, and then at month 6. Fluorescein angiography (FA) was performed at baseline and at the end of the study.. Fourteen eyes of 12 patients were included in the study, nine men and three women. Mean age was 58.5 years (range 32-80). Mean duration of SRF prior to study entry was 28.4 months. Forty-two percent of eyes were treated previously for CSR with thermal laser, PDT, or intravitreal bevacizumab. Mean best corrected visual acuity (BCVA) at presentation was 20/60 and improved to a mean of 20/50 at month 3 (P > 0.05). Retinal thickness was reduced by 25.3 %, 21.2 %, and 21 % on months 1, 2, 3, respectively (P < 0.05). Mean choroidal thickness at presentation was 476 μ (SD 188 μ) decreasing to 427 μ (SD 125 μ) after 3 months of treatment (P > 0.05). SRF was reduced in nine eyes (64 %) and completely resolved in six eyes (42.8 %) at month 3 following 3 months of treatment, and four out of these six eyes remained fluid free at month 6. Two patients stopped the treatment after 2 months due to adverse events.. Oral Rifampin may be a therapeutic option in patients with longstanding chronic CSCR.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Central Serous Chorioretinopathy; Chronic Disease; Cytochrome P-450 CYP3A Inducers; Female; Fluorescein Angiography; Humans; Male; Middle Aged; Pilot Projects; Prospective Studies; Retina; Rifampin; Subretinal Fluid; Tomography, Optical Coherence; Visual Acuity

Bartonellosis affects small Andean communities in Peru, Colombia and Ecuador. Research in this area has been limited.. Retrospective review of 191 cases of bartonellosis managed in Caraz District Hospital, Peru, during the last outbreak (2003).. The majority of cases (65%) were 14 years old and younger. There was a peak in acute cases after the rainy season; chronic cases presented more constantly throughout the year. The sensitivity of blood smear against blood culture in acute disease was 25%. The most commonly used treatment for chronic disease was rifampicin; chloramphenicol was used to treat most acute cases. Complications arose in 6.8% and there were no deaths.. Diagnostic and treatment algorithms for acute and chronic bartonellosis have been developed without a strong evidence base. Preparation of ready-to-go operational research protocols for future outbreaks would strengthen the evidence base for diagnostic and treatment strategies and enhance opportunities for control.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Bartonella bacilliformis; Bartonella Infections; Child; Child, Preschool; Chloramphenicol; Chronic Disease; Disease Outbreaks; Female; Humans; Infant; Male; Middle Aged; Peru; Rifampin

The authors present three cases of chronic central serous retinopathy in which rifampin was used for the utility of its oral delivery in remote care and as an alternative to photodynamic therapy when intravenous access was not possible. In each of these cases, a reduction of subfoveal fluid and improvement of visual acuity were achieved.

Topics: Administration, Oral; Adult; Central Serous Chorioretinopathy; Chronic Disease; Cytochrome P-450 CYP3A Inducers; Fluorescein Angiography; Humans; Male; Middle Aged; Rifampin; Subretinal Fluid; Tomography, Optical Coherence; Visual Acuity

The purpose of this study was to investigate the curative effect of bone-like hydroxyapatite/poly amino acid (BHA/PAA) as a carrier for poly(lactic-co-glycolic acid)-coated rifapentine microsphere (RPM) in the treatment of rabbit chronic osteomyelitis induced by Staphylococcus aureus.. RPM was prepared through an oil-in-water emulsion solvent evaporation method, and RPM was combined with BHA/PAA to obtain drug-loaded, slow-releasing materials. Twenty-six New Zealand white rabbits were induced to establish the animal model of chronic osteomyelitis. After debridement, the animals were randomly divided into three groups (n=8): the experimental group (with RPM-loaded BHA/PAA), the control group (with BHA/PAA), and the blank group. The RPM-loaded BHA/PAA was evaluated for antibacterial activity, dynamics of drug release, and osteogenic ability through in vitro and in vivo experiments.. In vitro, RPM-loaded BHA/PAA released the antibiotics slowly, inhibiting the bacterial growth of S. aureus for up to 5 weeks. In vivo, at week 4, the bacterial colony count was significantly lower in the experimental group than in the control and blank groups (P<0.01). At week 12, the chronic osteomyelitis was cured and the bone defect was repaired in the experimental group, whereas the infection and bone defect persisted in the control and blank groups.. In vitro and in vivo experiments demonstrated that RPM-loaded BHA/PAA effectively cured S. aureus-induced chronic osteomyelitis. Therefore, BHA/PAA has potential value as a slow-releasing material in clinical setting. Further investigation is needed to determine the optimal dosage for loading rifapentine.

Topics: Amino Acids; Animals; Anti-Bacterial Agents; Chronic Disease; Delayed-Action Preparations; Drug Carriers; Durapatite; Lactic Acid; Microspheres; Osteomyelitis; Polyglycolic Acid; Polylactic Acid-Polyglycolic Acid Copolymer; Rabbits; Rifampin; Staphylococcal Infections; Staphylococcus aureus

DNA gyrase is a clinically validated target for developing drugs against Mycobacterium tuberculosis (Mtb). Despite the promise of fluoroquinolones (FQs) as anti-tuberculosis drugs, the prevalence of pre-existing resistance to FQs is likely to restrict their clinical value. We describe a novel class of N-linked aminopiperidinyl alkyl quinolones and naphthyridones that kills Mtb by inhibiting the DNA gyrase activity. The mechanism of inhibition of DNA gyrase was distinct from the fluoroquinolones, as shown by their ability to inhibit the growth of fluoroquinolone-resistant Mtb. Biochemical studies demonstrated this class to exert its action via single-strand cleavage rather than double-strand cleavage, as seen with fluoroquinolones. The compounds are highly bactericidal against extracellular as well as intracellular Mtb. Lead optimization resulted in the identification of potent compounds with improved oral bioavailability and reduced cardiac ion channel liability. Compounds from this series are efficacious in various murine models of tuberculosis.

Topics: Acute Disease; Administration, Oral; Animals; Antitubercular Agents; Bacterial Proteins; Biological Availability; Chronic Disease; DNA Gyrase; Drug Resistance, Bacterial; ERG1 Potassium Channel; Ether-A-Go-Go Potassium Channels; Fluoroquinolones; Humans; Macrophages; Mice, Inbred BALB C; Microbial Sensitivity Tests; Molecular Docking Simulation; Mutation; Mycobacterium tuberculosis; Piperidines; Protein Subunits; Rats; Stereoisomerism; Structure-Activity Relationship; Topoisomerase II Inhibitors; Tuberculosis, Pulmonary

The Burkholderia cepacia complex (Bcc) represents an important group of pathogens involved in long-term lung infection in cystic fibrosis (CF) patients. A positive selection of hypermutators, linked to antimicrobial resistance development, has been previously reported for Pseudomonas aeruginosa in this chronic infection setting. Hypermutability, however, has not yet been systematically evaluated in Bcc species. A total of 125 well characterized Bcc isolates recovered from 48 CF patients, 10 non-CF patients and 15 environmental samples were analyzed. In order to determine the prevalence of mutators their spontaneous mutation rates to rifampicin resistance were determined. In addition, the genetic basis of the mutator phenotypes was investigated by sequencing the mutS and mutL genes, the main components of the mismatch repair system (MRS). The overall prevalence of hypermutators in the collection analyzed was 13.6%, with highest occurrence (40.7%) among the chronically infected CF patients, belonging mainly to B. cenocepacia, B. multivorans, B. cepacia, and B. contaminans -the most frequently recovered Bcc species from CF patients worldwide. Thirteen (76.5%) of the hypermutators were defective in mutS and/or mutL. Finally, searching for a possible association between antimicrobial resistance and hypermutability, the resistance-profiles to 17 antimicrobial agents was evaluated. High antimicrobial resistance rates were documented for all the Bcc species recovered from CF patients, but, except for ciprofloxacin, a significant association with hypermutation was not detected. In conclusion, in the present study we demonstrate for the first time that, MRS-deficient Bcc species mutators are highly prevalent and positively selected in CF chronic lung infections. Hypermutation therefore, might be playing a key role in increasing bacterial adaptability to the CF-airway environment, facilitating the persistence of chronic lung infections.

Topics: Anti-Bacterial Agents; Burkholderia cepacia complex; Burkholderia Infections; Chronic Disease; Cohort Studies; Cystic Fibrosis; DNA Mismatch Repair; DNA Repair Enzymes; DNA, Bacterial; Drug Resistance, Bacterial; Environmental Microbiology; Humans; Molecular Sequence Data; Mutation Rate; Respiratory Tract Infections; Rifampin; Sequence Analysis, DNA

The purpose of this report is to present a case of hepatotoxicity secondary to off-label rifampin therapy for the treatment of chronic central serous choroidopathy.. Case report.. A patient with chronic central serous chorioretinopathy was treated with oral rifampin. Three weeks after the initiation of therapy, fatigue, nausea, and malaise associated with elevated liver enzyme elevations were noted. Symptoms resolved and liver enzymes normalized after discontinuing rifampin.. Rifampin-induced hepatic injury can occur during therapy for chronic central serous chorioretinopathy. Potential hepatotoxicity must be considered and followed closely during off-label rifampin treatment.

Topics: Aged; Central Serous Chorioretinopathy; Chemical and Drug Induced Liver Injury; Chronic Disease; Humans; Male; Nucleic Acid Synthesis Inhibitors; Rifampin

Chronic airway infection with methicillin-resistant Staphylococcus aureus (MRSA) in patients with cystic fibrosis (CF) is an increasing clinical problem, and therapeutic options are limited. Because chronic infection with MRSA can be associated with accelerated decline in lung function, eradication of MRSA is attempted in most CF centres today. The aim of this observational prospective cohort study was to determine whether it is possible to eradicate MRSA from airways of CF patients using prolonged oral antibiotic combination therapy together with topical decolonization measures.. Eleven CF patients, (median age: 9 years (range 1-43); median FEV1: 91%pred (95%CI 74%-100%pred)) who were chronically infected with MRSA, were treated daily for six months with rifampicin and fusidic acid orally. This study did not include a patient control group. Two patients had to switch to an alternative schedule, using rifampicin and clindamycin, due to the resistance pattern of MRSA. Topical decolonization measures were applied to all patients and included mupirocin-containing nasal ointment in both nostrils three times daily for five days and chlorhexidine hair and body wash once daily for five days. Microbiological eradication was achieved in all patients at the end of the six-month eradication protocol, even when significant time (range 18 months to 9 years) had elapsed since initial isolation. In only one patient MRSA reappeared in the six-month follow-up period after the initial study period. Side-effects, like nausea, vomiting and diarrhoea were seen in five out of eleven patients, but did not lead to therapy cessation.. Chronic MRSA infection can be eradicated from respiratory tract samples using a six month dual antibiotic regimen and topical MRSA decolonization measures.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Child; Child, Preschool; Chronic Disease; Cystic Fibrosis; Disease Eradication; Female; Forced Expiratory Volume; Humans; Infant; Male; Methicillin-Resistant Staphylococcus aureus; Mupirocin; Nasal Mucosa; Nucleic Acid Synthesis Inhibitors; Ointments; Prospective Studies; Rifampin; Staphylococcal Infections; Young Adult

Topics: Aged; Antitubercular Agents; Bacteriological Techniques; Chronic Disease; Diagnostic Errors; DNA, Bacterial; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Lupus Vulgaris; Male; Mycobacterium tuberculosis; Polymerase Chain Reaction; Predictive Value of Tests; Rifampin; Skin; Time Factors; Treatment Outcome; Tuberculin Test

Tuberculosis (TB) is one of the leading casues of morbidity and death in a number of countries worldwide. A healthy 42-year-old patient presented with a chronic palatal ulcer that was not responsive to routine antibiotic treatment. A biopsy and further systemic investigation revealed a diagnosis of TB. An eight-month extended course of oral rifampin and isoniazid was instituted successfully resulting in complete resolution of symptoms. It is important that clinicians be aware that chronic oral ulcerations may be the first sign of systemic disease. A biopsy should therefore be mandatory for any chronic oral ulcer not responsive to conventional treatment.

Topics: Adult; Antitubercular Agents; Chronic Disease; Humans; Isoniazid; Male; Mouth Mucosa; Mycobacterium tuberculosis; Oral Ulcer; Rifampin; Treatment Outcome; Tuberculosis, Oral; Tuberculosis, Pulmonary

Chronic central serous retinopathy (CSR) is characterised by frequent exacerbations and a poor visual prognosis. Very few therapies exist for chronic CSR, and the existing therapies are often ineffective. Thus, novel therapies to combat this frustrating disorder are needed. Presented here is a case detailing a patient with chronic CSR with persistent subfoveal fluid of 2 years' duration that completely resolved with 1 month of oral rifampin therapy. As a cytochrome P450, 3A4 inducer, rifampin is thought to favourably alter the metabolism of endogenous steroids, thereby leading to an improvement in CSR manifestations.

Topics: Administration, Oral; Aged; Cataract Extraction; Central Serous Chorioretinopathy; Chronic Disease; Cytochrome P-450 CYP3A; Humans; Male; Nucleic Acid Synthesis Inhibitors; Postoperative Complications; Remission Induction; Rifampin

To assess the activity of clofazimine (CFZ) against Mycobacterium tuberculosis persisters using an oxygen depletion model and a low-dose aerosol mouse model of chronic tuberculosis (TB).. In in vitro experiments, CFZ showed much better activity than isoniazid under anaerobic conditions. In a low-dose aerosol mouse model of TB, we evaluated the efficacy of CFZ and moxifloxacin at different doses following treatment durations of 30, 60 and 90 days.. CFZ showed significant bactericidal activity in the mouse model over the wide dose range of 2-200 mg/kg. CFZ activity was dose-dependent. The bacilli were eradicated in the CFZ 200 mg/kg group after treatment for 60 days, and in the CFZ 20 mg/kg group after 90 days of treatment.. CFZ exhibits dose-dependent, sustained bactericidal activity against M. tuberculosis persisters, and thus warrants further study to demonstrate its potential to contribute significantly in a novel treatment-shortening regimen.

Topics: Animals; Antitubercular Agents; Aza Compounds; Chronic Disease; Clofazimine; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Resistance, Bacterial; Fluoroquinolones; Isoniazid; Male; Mice; Mice, Inbred BALB C; Microbial Sensitivity Tests; Moxifloxacin; Mycobacterium tuberculosis; Quinolines; Rifampin; Time Factors; Tuberculosis, Pulmonary

Lupus vulgaris (LV) is a chronic, progressive, and potentially destructive form of cutaneous tuberculosis commonly seen in previously sensitized individuals with moderate to high immunity. We present a case of LV located on the nose of an 84-year-old female patient, discuss the diagnosis and treatment modalities, and emphasize the importance of having a high index of suspicion for this condition.

Topics: Aged, 80 and over; Antitubercular Agents; Chronic Disease; Ethambutol; Female; Humans; Isoniazid; Lupus Vulgaris; Mycobacterium tuberculosis; Nose Diseases; Pyrazinamide; Rifampin; Skin Ulcer; Treatment Outcome; Tuberculosis, Pulmonary

A case of intestinal tuberculosis affecting the jejunum (with perforations) and the colon is presented. The objective is to highlight the challenges medical practitioners face in making a timely diagnosis of intestinal tuberculosis. It also aims to raise awareness that chronic diarrhoea and weight loss are common symptoms of colonic tuberculosis. A 26 year old university student was admitted with a three month history of diarrhoea anorexia and weight loss having been seen and treated for typhoid in several hospitals without improvement. Colonoscopy and biopsy was non conclusive. He later developed subacute intestinal obstruction that did not respond to conservative treatment. Explorative laparotomy revealed jejunal perforations with localised absesses, peritoneal adhesions with caseous nodules and mesenteric Iymphadenopathy. Histology of resected specimens was positive for mycobacterium tuberculosis.

Topics: Adult; Antitubercular Agents; Chronic Disease; Diarrhea; Ethambutol; Humans; Isoniazid; Laparotomy; Male; Pyrazinamide; Rifampin; Tuberculosis, Gastrointestinal

Over six months, 129 consecutive brucellosis cases were diagnosed in females attending the outpatients' clinics the females in Al-Azhar and Ain Shams Universities Hospitals. Their ages ranged between 12-65 years old. 113 (87.6%) gave history of raw milk consumption, 13 (10%) gave history of home slaughtering of sheep, 2 (1.5%) gave history of animal contact, and one patient gave history of abortion, that partner had brucellosis. A total of 61.2% of patients gave serum agglutination test of 1: 640, who suffered acute or subacute infection. Titers of 1:320 (38.8%) were found in the majority of chronic cases. Causes of endemic parasitosis were excluded. Symptoms were fever (79.5%), headache (72.4%), generalized arthralgia (65.3%), sweating (65.3%), chills (63.8%), backache (34.6%), abdominal pain (27.5%), loss of appetite (25.5%), lassitude (17.2%), myalgia (14.2%), monoarthralgia (7.9%). Spinal involvement was in 15% patients, who had chronic brucellosis. 32/35 were successfully treated with a combination of streptomycin and tetracycline, 17/21 with streptomycin and septrin, 38/43 with tetracycline and septrin, and 26/26 (100%) with rifampicin and tetracycline or septrin, which treated all resistant patients.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Anti-Bacterial Agents; Brucellosis; Child; Chronic Disease; Drug Therapy, Combination; Egypt; Female; Fever; Humans; Middle Aged; Rifampin; Risk Factors; Streptomycin; Tetracycline; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Aged; Bacteremia; Catheterization, Central Venous; Chronic Disease; Daptomycin; Discitis; Humans; Jugular Veins; Male; Methicillin-Resistant Staphylococcus aureus; Pancreatitis; Rifampin; Staphylococcal Infections; Vancomycin; Virginiamycin

Musculoskeletal symptoms are not infrequent in leprosy and, when inaugural, may be difficult to differentiate from other conditions, most notably rheumatoid arthritis. We report the case of a 24 year-old man with a 5 year history of intermittent inflammatory arthritis and fever. Physical findings and radiographs were normal initially. Several years later, he had severe wasting of the hand muscles, stocking-glove sensory loss, burn scars on the hands, and plantar ulcers. Electrophysiological test results indicated sensory-motor neuropathy with predominant demyelination. Laboratory tests showed inflammation without immunological abnormalities. A prominent endoneurial inflammatory infiltrate composed of mononuclear cells was seen on a nerve biopsy specimen, suggesting leprosy. A family study then revealed that the patient's aunt had been diagnosed with leprosy. Dapsone, clofazimine, and rifampin were given. The joint manifestations and laboratory tests for inflammation improved. However, no changes were noted in the neurological symptoms.

Topics: Adult; Arthritis; Chronic Disease; Clofazimine; Dapsone; Diagnosis, Differential; Drug Therapy, Combination; Electrophysiology; Humans; Leprostatic Agents; Leprosy, Borderline; Male; Musculoskeletal System; Neurons; Radiography; Rifampin; Toes

A 83-year-old man had been treated for pulmonary infiltration was referred to a nearby hospital because of slight fever and cough. His chest radiograph and CT showed right chronic empyema, and in which pleural aspirate was smear positive for acid-fast bacilli and positive for PCR-Mycobacterium intracellulare. He was diagnosed as chronic empyema caused by M. intracellulare. A month later exacerbation of bronchopleural fistula was observed and M. intracellulare infection expanded into the lung. He was treated with combined use of ethambutol, rifampicin, clarithromycin, and streptomycin for six months, and his chest radiograph showed improvement, however, finally he died as he was in advanced age and emaciation due to chronic lung infection.

Topics: Aged, 80 and over; Chronic Disease; Clarithromycin; Drug Therapy, Combination; Empyema; Ethambutol; Humans; Male; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Radiography, Thoracic; Rifampin; Streptomycin; Tomography, X-Ray Computed

To report a case of tuberculosis of the conjunctiva.. Case report with pathologic correlation. A 17-year-old man who had relocated to Australia from Liberia presented with chronic unilateral conjunctivitis.. The diagnosis was not initially evident, despite 2 separate biopsy specimens, conjunctival cultures, and polymerase chain reaction testing. Definitive diagnosis was made after repeated histologic examination. Antituberculous treatment resulted in prompt resolution of all ocular signs.. Tuberculous conjunctivitis is now a very rare condition in the developed world. Definitive diagnosis requires the identification of Mycobacterium tuberculosis organisms in conjunctival biopsy specimens-either through microscopic detection of acid-fast bacilli or more sensitive culture techniques.

Topics: Adolescent; Antitubercular Agents; Chronic Disease; Conjunctivitis, Bacterial; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Male; Pyrazinamide; Rifampin; Tuberculosis, Ocular

Brucellosis is one of the important health problems for both humans and animals in Turkey since agriculture and stock raising appears to be the most important means of subsistence. Investigations on the pathogenesis of brucellosis reveal that the etiologic agent can survive in phagocytic cells, and cell-mediated immunity plays an important role in immunity against bacteria.. In this study, we investigated whether supplementation of levamisole, a well-known antihelminthic agent with immune-stimulating activity to conventional antibiotic therapy, would improve the anergy against Brucella.. The results of our study reveal that a 6-week course of levamisole as a supplement to conventional antibiotic therapy in chronic brucellosis is not superior to conventional antibiotic treatment alone with respect to lymphocyte subgroup ratios and phagocytic function.. In chronic brucellosis, levamisole administered as a supplement concomitantly with conventional antibiotic therapy has no immunostimulating effect on the basis of the lymphocyte subgroups ratios measured and the ability of phagocytosis in the present study. Further large clinical and laboratory trials are necessary to investigate the immunological and physiological effects of levamisole on T(H1) subtypes and cytokine secretion.

Topics: Brucella melitensis; Brucellosis; Chronic Disease; Combined Modality Therapy; Doxycycline; Drug Therapy, Combination; Female; Humans; Immunity, Cellular; Levamisole; Lymphocytes; Male; Phagocytosis; Rifampin; Turkey

The mechanisms by which brucellae evade intracellular killing by polymorphonuclear leukocytes are incompletely understood. In this study, we evaluated changes of leukocyte superoxide dismutase (SOD) activity and plasma total nitrite as an indicator of nitric oxide (NO) levels during brucellosis therapy.. Thirty-two patients with acute brucellosis, 27 patients with chronic brucellosis and 30 healthy controls were included in the study. Patients with acute brucellosis were tested for leukocyte SOD activity and plasma total nitrite levels before, during (21st day), and at the end (45th day) of the combined therapy of rifampicin and doxycycline. The same parameters were also investigated in chronic cases and controls.. The SOD activities were lower in patients with acute brucellosis before therapy compared with those 21 and 45 days after starting therapy (P < 0.001). In contrast, total nitrite levels did not change significantly (P > 0.05).. In the present study, leukocyte SOD activity was found to be decreased in patients with acute brucellosis. Enzyme activity was increased by treatment, finally reaching the activity of healthy controls. Using an antioxidant agent in addition to classical antimicrobial therapy for acute brucellosis might be a therapeutic approach.

Topics: Acute Disease; Antioxidants; Brucellosis; Chronic Disease; Doxycycline; Female; Humans; Leukocytes; Male; Nitric Oxide; Nitrites; Rifampin; Superoxide Dismutase

The tuberculostatic compound rifampin (INN, rifampicin) induces the expression of a number of drug metabolism-related genes involved in multidrug resistance (P-glycoprotein and multidrug resistance proteins 1 and 2), cytochromes (cytochrome P450 [CYP] 3A4), uridine diphosphate-glucuronosyltransferases, monoamine oxidases, and glutathione S -transferases. Drugs that depend on these enzymes for their metabolism are prone to drug interactions when coadministered with rifampin. A novel, clinically relevant drug interaction is described between rifampin and mycophenolate mofetil (MMF), a cornerstone immunosuppressive molecule used in solid organ transplantation. Long-term rifampin therapy caused a more than twofold reduction in dose-corrected mycophenolic acid (MPA) exposure (dose-interval area under the concentration curve from 0 to 12 hours [AUC 0-12]) when administered simultaneously in a heart-lung transplant recipient, whereas subsequent withdrawal of rifampin resulted in reversal of these changes after 2 weeks of washout (dose-corrected AUC 0-12 after rifampin withdrawal, 19.7 mg.h.L-1.g -1 versus 6.13 mg.h.L-1.g-1 before rifampin withdrawal [221% change]; dose-uncorrected AUC 0-12 after rifampin withdrawal, 29.6 mg.h/L [daily MMF dose, 3 g] versus 18.4 mg.h/L [daily MMF dose, 6 g] during rifampin administration [60.8% change]). Failure to recognize this drug interaction could potentially lead to MPA underexposure and loss of clinical efficacy. The effect of rifampin on MPA metabolism can, at least in part, be explained by simultaneous induction of renal, hepatic, and gastrointestinal uridine diphosphate-glucuronosyltransferases and organic anion transporters with subsequent functional inhibition of enterohepatic recirculation of MPA.

Topics: Area Under Curve; Chronic Disease; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Interactions; Drug Therapy, Combination; Enterohepatic Circulation; Glucuronosyltransferase; Heart-Lung Transplantation; Histiocytosis, Langerhans-Cell; Humans; Hypertension, Pulmonary; Male; Metabolic Clearance Rate; Middle Aged; Mycophenolic Acid; Pharmacology, Clinical; Respiratory Insufficiency; Rifampin; Tacrolimus; Time Factors; Uridine Diphosphate; Withholding Treatment

Coxiella burnetii, the etiologic agent of Q fever, is mainly responsible for endocarditis with negative blood culture results, but only a few cases of C. burnetii infections of aortic aneurysms have been published. We report three cases of abdominal aortic aneurysms treated in patients with Q fever infection with simultaneous endocarditis (n = 1) and previous history of cardiac valve replacement for endocarditis (n = 1). A coeliac aortic aneurysm was diagnosed in one patient treated for acute Q fever with persistent serologic results showing chronic infection despite adequate antibiotic therapy and without endocarditis. Resection of the aneurysm cured the chronic infection, and C. burnetii was identified by culture of the aneurysmal wall. In the two other cases, chronic infection of C. burnetii was diagnosed by serologic examination after surgery for an abdominal aortic aneurysm. One patient with negative blood culture results had amaurosis fugax due to endocarditis and required aortic valve replacement; recurrent fever without evidence of valve dysfunction or infection developed in one patient who had had prosthetic cardiac valve replacement 6 months earlier for endocarditis. Aortic aneurysms were treated with in situ prosthetic grafts and long-term antibiotic therapy. At a mean follow-up of 12 years, no septic aortic complications occurred, and serologic test results have remained negative. The presence of an aortic aneurysm and cardiac valve disease seems to be a predisposing factor for chronic C. burnetii infection. Diagnosis particularly relies on the physician's awareness of this condition and is confirmed by serologic examination. Aortic aneurysm resection is mandatory to cure the chronic infection and must be associated with long-term antibiotic therapy.

Topics: Aged; Aneurysm, Infected; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis Implantation; Chronic Disease; Doxycycline; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Heart Valve Prosthesis Implantation; Humans; Iliac Artery; Male; Middle Aged; Q Fever; Rifampin

Acinetobacter baumannii is a well-known cause of hospital-acquired pneumonia. Occasionally, it can present as an acute community-acquired pneumonia with a fulminant course. However, the occurrence of the chronic form of community-acquired Acinetobacter pneumonia is yet to be highlighted. We describe a 62-year-old, HIV negative, non-diabetic male, who was referred for evaluation of consolidation and cavitation in the apicoposterior segment of the left upper lobe for 4 months. For this, he had received anti-tuberculous therapy, which included rifampicin. On investigation, a diagnosis of chronic community-acquired pneumonia due to Acinetobacter baumannii was made. The steady clinico-radiologic improvement observed was attributed to rifampicin in the anti-tuberculous regime. Subsequently, an aspergilloma formed in the cavity.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Antibiotics, Antitubercular; Chronic Disease; Community-Acquired Infections; Humans; Male; Pneumonia, Bacterial; Rifampin; Time Factors; Treatment Outcome

Nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) to patients with cystic fibrosis (CF) frequently results in chronic respiratory tract carriage. This is an increasing problem, adds to the burden of glycopeptide antibiotic use in hospitals, and represents a relative contraindication to lung transplantation. The aim of this study was to determine whether it is possible to eradicate MRSA with prolonged oral combination antibiotics, and whether this treatment is associated with improved clinical status. Adult CF patients (six male, one female) with chronic MRSA infection were treated for six months with rifampicin and sodium fusidate. Outcome data were examined for six months before treatment, on treatment and after treatment. The patients had a mean age of 29.3 (standard deviation=6.3) years and FEV(1) of 36.1% (standard deviation=12.7) predicted. The mean duration of MRSA isolation was 31 months. MRSA isolates identified in these patients was of the same lineage as the known endemic strain at the hospital when assessed by pulsed-field gel electrophoresis. Five of the seven had no evidence of MRSA during and for at least six months after rifampicin and sodium fusidate. The proportion of sputum samples positive for MRSA was lower during the six months of treatment (0.13) and after treatment (0.19) compared with before treatment (0.85) (P<0.0001). There was a reduction in the number of days of intravenous antibiotics per six months with 20.3+/-17.6 on treatment compared with 50.7 before treatment and 33.0 after treatment (P=0.02). There was no change in lung function. Gastrointestinal side effects occurred in three, but led to therapy cessation in only one patient. Despite the use of antibiotics with anti-staphylococcal activity for treatment of respiratory exacerbation, MRSA infection persists. MRSA can be eradicated from the sputum of patients with CF and chronic MRSA carriage by using rifampicin and sodium fusidate for six months. This finding was associated with a significant reduction in the duration of intravenous antibiotic treatment during therapy.

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Carrier State; Chronic Disease; Cross Infection; Cystic Fibrosis; Female; Fusidic Acid; Humans; Male; Methicillin Resistance; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome

To investigate the risk factor of treatment failure of pulmonary tuberculosis excluding multi-drug resistant cases from the standpoint of both clinical management and tuberculosis control.. Retrospective chart review of patients who admitted to Fukujuji Hospital for treatment failure of pulmonary tuberculosis excluding multi-drug resistant cases from Jan. 1993 to Dec. 2003.. Out of 24 treatment failure cases available for analysis, 4 cases were associated with chronic tuberculous empyema with broncho-pleural fistula, and among them, chronic empyema was considered to be the main cause of treatment failure in one case. In 6 cases, poor adherence to medication was confirmed or suspected, and 2 of these 6 cases was also associated with miss-management. In 9 cases miss-management was found without poor adherence or chronic empyema, and in 8 out of these 9 cases, miss-management was considered to be the main cause of treatment failure. In 5 cases no apparent risk factor was found, but in 2 out of these 5 cases the ignorance of the results of drug sensitivity tests (and, therefore, miss-management) was strongly suspected. Summing up, in 10 out of 24 cases (41.7%), the miss-management was considered to be the main cause of treatment failure, and it was more frequently seen than poor adherence to medication.. Clinicians should be aware of these risk factors of treatment failure such as chronic empyema, weak regimen in bacteriological negative cases, rifampicin+ethambutol regimen, and miss-management of drug adverse effect. From the standpoint of tuberculosis control in Japan we considered that, in addition to DOT, strategy to secure the quality of tuberculosis treatment is by all means needed.

Topics: Adult; Aged; Antitubercular Agents; Chronic Disease; Directly Observed Therapy; Drug Therapy, Combination; Empyema, Tuberculous; Ethambutol; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Patient Compliance; Quality of Health Care; Retrospective Studies; Rifampin; Risk Factors; Treatment Failure; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary

An 11-year-old boy presented with chronic meningitis followed by acute flaccid paralysis. The aetiology remained uncertain until the brucellar serology test became positive and there was a good response to specific antimicrobial therapy. Nerve conduction studies confirmed a proximal radiculopathy. Awareness of the condition and performance of the appropriate tests will differentiate neurobrucellosis from other chronic central nervous system infections.

Topics: Anti-Bacterial Agents; Brucellosis; Central Nervous System Bacterial Infections; Child; Chronic Disease; Doxycycline; Humans; Male; Meningitis, Bacterial; Neural Conduction; Paralysis; Radiculopathy; Rifampin

The patient was a 74 year-old male presenting right pleural effusion with mild fever. His temperature was 37.0 degrees C. Culture of a pleural biopsy specimen revealed Mycobacterium tuberculosis, although culture of sputum and pleural effusion were negative. Therapy was begun with 300 mg of isoniazid (INH) per day, 600 mg of rifampicin (RFP) per day, and 1200 mg of pyrazinamide (PZA) per day. His temperature improved temporarily. One week after beginning of the therapy he had a fever over 38.0 degrees C. On the 17th day after starting chemotherapy, a chest radiological examination showed left pleural effusion in which numerous lymphocytes were found but Mycobacterium tuberculosis was negative. We assumed that the left pleural effusion was due to a paradoxical reaction to the anti-tuberculosis chemotherapy. After 3 days' discontinuation, the same regimen was resumed with an addition of prednisolone, but bilateral pleural effusion remained and the case finally fell into chronic respiratory failure.

Topics: Aged; Antitubercular Agents; Chronic Disease; Drug Therapy, Combination; Humans; Isoniazid; Male; Pleural Effusion; Pyrazinamide; Respiratory Insufficiency; Rifampin; Tuberculosis, Pleural

With the aim to estimate the clinical and immunological efficiency of the ciprofloxacin (cifloxinal) 105 patients with acute (51), subacute (19) and chronic (35) brucellosis were studied. Control group (17 patients with acute and 30 patients with chronic brucellosis) have been treated with combination of two antibiotics: doxycycline and rifampicin. Ciprofloxacin in a dose 500 mg bid within 14 days in acute stage and 20 days in chronic stage of disease essentially reduced duration of local inflammatory processes of brucellosis with simultaneous treatment of the chronic infection focus, provides good proximate and distant outcomes of treatment. Ciprofloxacin can be considered as an alternative drug for the treatment of brucellosis, more effective (clinically and immunologically) than a combination of two antibiotics: doxycycline and rifampicin.

Topics: Acute Disease; Adult; Antibody Formation; Brucella melitensis; Brucellosis; Chronic Disease; Ciprofloxacin; Doxycycline; Drug Therapy, Combination; Humans; Middle Aged; Rifampin; Severity of Illness Index; Treatment Outcome

The interest of the management of bone infections in the diabetic foot, inspired by the recommendations for the treatment of chronic osteitis, was assessed in this study.. Twenty bone infections in 17 diabetic patients with moderate to mild infections of the feet were confirmed by the results of X-ray and/or scintigraphic studies and bone surgery biopsy cultures revealing one or more bacteria sensitive to standard osteitis treatment (rifampicine + fluoroquinolone). The patients had received this treatment per os for a median duration of 6 months (3 to 10 months). Clinical follow-up was carried out during a consultation at 1, 3 and 6 months during treatment and then by telephone every six months after the end of treatment. Clinical success was defined as the disappearance of any local sign of infection and by the absence of relapse during the post-treatment follow-up period. The evolution of the bone infection was also assessed by the results of a control conducted 3 to 6 months after initiation of the antibiotic treatment.. At the end of the treatment, all signs of infection had disappeared in 15/17 patients (88.2%) and no relapse had occurred in 14 (82.3%) patients at the end of a median post-treatment period of 22 months (12 to 41 months). Resection of necrotic bone was performed at the same time as the bone biopsy in 2 patients. The median duration of hospitalisation was of 14 days (3 to 53 days). During the study, a multi-resistant germ was isolated in 4 patients (1 Pseudomonas aeruginosa, 3 Staphylococcus aureus). During the post-treatment follow-up, 3 patients dies from causes unrelated to the infection treated. No serious adverse event was reported during the study.. The results of this pilot study support the rationale of applying the treatment regimens of chronic osteitis to diabetic lesions of the feet, but are only applicable to comparable patients presenting with non-severe lesions of the feet. Moreover, the use of antibiotics with potent selection of resistance such as rifampicine and fluoroquinolone, requires that bone biopsies be taken, which is not easy in all the diabetic foot care centres. We are presently conducting a study to identify the sub-populations of diabetic patients who could benefit from such treatment.

Topics: Aged; Anti-Infective Agents; Antibiotics, Antitubercular; Biopsy; Chronic Disease; Diabetic Foot; Drug Resistance, Multiple; Female; Fluoroquinolones; Humans; Male; Middle Aged; Osteitis; Pseudomonas aeruginosa; Pseudomonas Infections; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome

We report a case of chronic wound infection (abscess, fistula) after a Lichtenstein repair of inguinal hernia. After surgical treatment (mesh explantation), a small-colony variant (SCV) of Staphylococcus aureus was cultured microbiologically. SCV represent subpopulations of Staphylococcus aureus which are associated with chronic infections and which respond poorly to usual treatment regimes. In this case surgery and specific antibiotic treatment with flucloxacillin and rifampicin were successful.

Topics: Abscess; Chronic Disease; Combined Modality Therapy; Cutaneous Fistula; Floxacillin; Hernia, Inguinal; Humans; Male; Middle Aged; Postoperative Complications; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Surgical Wound Infection

Acanthamoeba was implicated as the causative agent of chronic meningitis in three apparently immunocompetent children. Diagnosis was established by cerebrospinal fluid wet mount examination and culture. Two children improved rapidly with combination oral therapy composed of trimethoprim-sulfamethoxazole, rifampin and ketoconazole.

Topics: Acanthamoeba; Administration, Oral; Amebiasis; Animals; Anti-Infective Agents; Antifungal Agents; Child; Child, Preschool; Chronic Disease; Drug Therapy, Combination; Enzyme Inhibitors; Female; Humans; Ketoconazole; Magnetic Resonance Imaging; Male; Meningitis; Rifampin; Trimethoprim, Sulfamethoxazole Drug Combination

Bartonellosis remains a major problem in Peru, but many contemporary aspects of this disease have not been adequately described. We examined the cases of 145 symptomatic patients in Lima, Peru, in whom bartonellosis was diagnosed from 1969 through 1992, including 68 patients in the acute (hematic) phase and 77 patients in the eruptive (verruga) phase. In modern Peru, symptomatic patients who have acute-phase bartonellosis typically present with a febrile illness and systemic symptoms caused by profound anemia; most patients respond successfully to treatment with chloramphenicol. Patients who have eruptive-phase bartonellosis most often present with cutaneous verrugas but may have less specific symptoms, such as fever and arthralgias; diagnosis can be confirmed in such patients by Western immunoblotting, and most patients appear to respond to treatment with rifampin.

Topics: Acute Disease; Adolescent; Adult; Anti-Bacterial Agents; Bartonella Infections; Child; Child, Preschool; Chloramphenicol; Chronic Disease; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Peru; Pregnancy; Pregnancy Complications, Infectious; Rifampin

Seventeen diabetic patients with moderate to mild foot lesions associated with 20 osteomyelitic bones diagnosed by both bone scan and bone biopsy received rifampicin plus ofloxacin for a median duration of 6 months. Cure was defined as disappearance of all signs and symptoms of infection at the end of the treatment and absence of relapse during follow up. At the end of the treatment period, cure was achieved in 15 patients (88.2%) and was maintained in 13 patients (76.5%) at the end of an average post-treatment follow-up of 22 months. No serious drug-related adverse events were recorded.

Topics: Administration, Oral; Aged; Anti-Infective Agents; Antibiotics, Antitubercular; Bacterial Infections; Chronic Disease; Diabetic Foot; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Male; Middle Aged; Ofloxacin; Osteomyelitis; Rifampin; Treatment Outcome

The authors studies 98 patients (82 males and 16 females) in 1994-1996. The patients were found sputum Mycobacteria tuberculosis (MT) resistant to two essential antituberculosous drugs: isoniazid and rifampicin. In 67 (68.4%) cases MT resistance was verified in other laboratories of the country. The examinees were 13 new cases and 17 had relapses. Sixty eight patients were diagnosed as having chronic tuberculosis. After multidrug resistant strains were identified, the patients were treated by an individual regimens by choosing adequate drugs from different groups. Twenty patients were operated on. Sputum conversion occurred in only 24 (24.5%) patients. In 14 of them clinical and X-ray lesion disappeared. In 74 (75%) good treatment outcomes were not achieved and MT remained in the sputum. There were statistically significant differences in the treatment outcomes among new, relapsing, and chronic cases (poor treatment outcomes were in 38.5, 64.7, and 85.3%, respectively). The surgical outcomes proved to be no better than those in drug-treated patients due to the incorrect definition of indications for surgery or advanced disease. The findings show that the outcomes were poor in chronic MT multidrug-resistant patients and fair results could be achieved in new cases of the disease diagnosed in time.

Topics: Adult; Aged; Antitubercular Agents; Chronic Disease; Female; Hospitals, State; Humans; Incidence; Isoniazid; Lithuania; Male; Middle Aged; Pneumonectomy; Retrospective Studies; Rifampin; Treatment Outcome; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary

Topics: Abscess; Adult; Antitubercular Agents; Chronic Disease; Drug Therapy, Combination; Ethambutol; Female; Graft Rejection; Humans; Isoniazid; Kidney Transplantation; Nephrectomy; Pyrazinamide; Reoperation; Rifampin; Tuberculosis

Eight patients presented neurological signs secondary to Brucella infection. The clinical presentation was a meningoencephalitis in three cases, a meningoencephalomyelitis in one case, an epiduritis with spinal cord compression in one case, an acute polyradiculoneuritis in two cases and a chronic polyradiculoneuritis in one case. Acoustic nerve was impaired in seven cases. Cerebrospinal fluid (CSF) analysis revealed a lymphocytic meningitis and a high protein concentration in all cases. The agglutination test titers were elevated in the serum and in the CSF of seven patients (> or = 1/80) and two patients respectively. Brucella melitensis culture was disclosed in the blood of one patient and in the CSF of two patients. Three patients were treated by the association cycline and rifampicin whereas a tritherapy including cycline, rifampicin and TMP-SMZ was used in the other cases. Outcome was favorable in seven cases. This study outlines the polymorphism of neurological manifestations due to brucellosis, even in familial cases and this diagnostic must be especially done in Middle East and South Mediterranean countries.

Topics: Acute Disease; Adolescent; Adult; Aged; Agglutination Tests; Brucellosis; Chronic Disease; Enzyme Inhibitors; Female; Humans; Male; Mediterranean Region; Meningoencephalitis; Middle Aged; Middle East; Polyradiculoneuropathy; Retrospective Studies; Rifampin; Spinal Cord Compression; Tetracyclines

Mycobacterium thermoresistibile was isolated in pure culture from ultrasound-guided pulmonary aspirates taken from a young cat with severe, chronic, pyogranulomatous pneumonia. Thoracic radiography and ultrasonography before therapy demonstrated severe diffuse alveolar disease. Twelve months combination therapy with doxycycline, rifampicin and clarithromycin resolved the infection. Thoracic radiographs taken at the completion of therapy showed multifocal pulmonary mineralisation. M thermoresistibile has been infrequently reported as a human or animal pathogen. This is the first reported pulmonary infection by M thermoresistibile in a cat and documents the successful treatment of the organism in a feline patient.

Topics: Animals; Anti-Bacterial Agents; Cat Diseases; Cats; Chronic Disease; Clarithromycin; Doxycycline; Female; Mycobacterium; Pneumonia; Rifampin

We report three adult cases of very chronic, extensive infection of the lower limbs due to Mycobacterium marinum. The patients were from South Pacific islands and, clinically, the widespread warty plaques resembled chromomycosis. One was associated with severe lymphoedema. All three patients gave a history of at least 20 years duration. The patients were otherwise well and not immunologically compromised. In all cases, the organism was identified on tissue cultures and was not seen on histopathology. The mycobacteria were sensitive to most antibiotics tested in vitro. The patients were treated with a combination of rifampicin and cotrimoxazole with good results.

Topics: Adult; Aged; Anti-Bacterial Agents; Antibiotics, Antitubercular; Chromoblastomycosis; Chronic Disease; Culture Techniques; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Leg Dermatoses; Lymphedema; Male; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Pacific Islands; Rifampin; Time Factors; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Prostatitis due to vancomycin-resistant enterococci has not been previously described. Reported here is a case of chronic prostatitis due to Enterococcus faecium, resistant to vancomycin, ampicillin, ciprofloxacin and doxycycline, in a 42-year-old liver transplant recipient. Treatment with a combination of rifampin and nitrofurantoin for 6 weeks resulted in long-lasting cure. Other antimicrobial agents active in vitro against vancomycin-resistant enterococci, such as quinupristin/ dalfopristin and chloramphenicol, are unlikely to achieve sufficient prostatic tissue levels to be successfully utilized for treatment of this condition.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Chronic Disease; Drug Resistance, Microbial; Drug Resistance, Multiple; Drug Therapy, Combination; Enterococcus faecium; Gram-Positive Bacterial Infections; Humans; Liver Transplantation; Male; Nitrofurantoin; Prostatitis; Rifampin; Urine; Vancomycin

The purpose of the present study was to evaluate the combination of azithromycin and rifampicin on experimental chronic osteomyelitis due to Staphylococcus aureus. Alterations in bone bacterial titre, activity of tumour necrosis factor (TNF), a cytokine implicated in inflammation-induced bone pathology, and histopathological changes during infection and following antibiotic treatment were evaluated. Rats were infected with S. aureus by direct tibial inoculation and then randomized 56 days after infection to receive saline treatment or a combination of azithromycin and rifampicin (50 mg/kg po and 25 mg/kg sc respectively) once daily for 21 days. The combination of azithromycin and rifampicin was successful as determined by dramatic reduction in bone bacterial counts (approximately log 4 cfu), but regrowth of the organisms occurred suggesting that the duration of treatment was insufficient. TNF alpha mRNA and TNF activity were constantly elevated by approximately 20- and >200-fold, respectively, and remained elevated irrespective of antimicrobial treatment. Bone histology revealed extensive increase in bone turnover in both the infected and antibiotic treated bones with no difference being observed between the groups. This suggests that, in infected bone, the elevated TNF levels observed may be directly related to the bone pathology and both remain largely unchanged despite potent antibiotic therapy.

Topics: Animals; Anti-Bacterial Agents; Antibiotics, Antitubercular; Azithromycin; Bone and Bones; Chronic Disease; Disease Models, Animal; Drug Therapy, Combination; Osteomyelitis; Rats; Rifampin; RNA, Messenger; Staphylococcus aureus; Tumor Necrosis Factor-alpha

To describe a case of chronic pancreatic insufficiency related to antituberculous therapy.. A 57-year-old man developed rash, fever, and hepatitis (aspartate aminotransferase 369 IU/L, alanine aminotransferase 506 IU/L), 6 weeks after starting isoniazid, rifampin, ethambutol, and pyrazinamide. He also developed severe metabolic acidosis secondary to diabetic ketoacidosis and lactic acidosis (serum bicarbonate 7 mEq/L, glucose 1778 mg/dL, and lactate 4.0 mEq/L). Acute pancreatitis was diagnosed on the basis of a mildly elevated amylase concentration (392 U/L) and radiologic evidence of pancreatic inflammation. He developed pancreatic insufficiency with steatorrhea and an abnormal secretin test. He continues to require pancreatic enzyme replacement and insulin therapy. Rechallenge was not performed.. Hypersensitivity syndromes have been reported for various drug therapies, including antituberculous agents. Hypersensitivity syndrome reactions are characterized by fever, rash, and internal organ involvement. Rifampin has been reported to cause acute pancreatitis in up to 2.7% of patients. Drug-induced chronic pancreatitis, however, is reported to be extremely rare. This is the first reported case of chronic pancreatic insufficiency occurring in the setting of a hypersensitivity syndrome reaction to antituberculous drugs.. Chronic pancreatic insufficiency should be considered as a possible long-term sequelae of a hypersensitivity syndrome reaction to antituberculous therapy.

Topics: Antitubercular Agents; Chronic Disease; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Exocrine Pancreatic Insufficiency; Humans; Isoniazid; Male; Middle Aged; Pyrazinamide; Rifampin

For many years, Rifampicin has been used empirically for the treatment of hemophilic chronic synovitis with encouraging results. A study was performed in which Rifampicin was shown to reduce the inflammation of joints affected by hemophilic synovitis. A clinical study was performed on 48 hemophilic patients (48 joints). Seventeen elbows, eight knees, and 23 ankles were treated. The mean age of the patients was 6 years (range, 4-23 years) and the mean followup was 29 months (range, 24-53 months). Overall, 40 excellent results and eight good results were obtained. The average number of weekly injections of Rifampicin was 3.06 (range, 1-10 injections). Eight patients experienced pain on the first injection, which subsided gradually with the subsequent procedures. Synoviorthesis with Rifampicin seems to be a good method for the treatment of hemophilic synovitis, especially in small joints (elbows and ankles) and in younger children.

Topics: Adolescent; Adult; Age Factors; Animals; Ankle Joint; Anti-Bacterial Agents; Arthralgia; Child; Child, Preschool; Chronic Disease; Disease Models, Animal; Elbow Joint; Follow-Up Studies; Forecasting; Hemarthrosis; Hemophilia A; Hemophilia B; Humans; Injections, Intra-Articular; Knee Joint; Logistic Models; Male; Rabbits; Rifampin; Synovitis; Treatment Outcome

Multidrug-resistant tuberculosis has emerged over the last two years at Carrasco Hospital, located in Rosario city. Nosocomial transmission among 7 AIDS patients admitted into the same ward between June and December/94 was supported by temporal clustering of cases, matching drug susceptibility, and identical IS6110 fingerprints. Among 8 non-HIV chronic cases without evidence of reciprocal contact outside the hospital, two additional clusters of 2 and 4 cases, respectively, were identified. The latter was found to be generated by a strain genetically related to the one that infected AIDS patients. It is hypothesized that an ancestor strain, common to both, might have been brought into the hospital long before the outbreak was first suspected.

Topics: Acquired Immunodeficiency Syndrome; Adult; Argentina; Chronic Disease; Cross Infection; DNA Fingerprinting; DNA, Bacterial; Ethambutol; Humans; Isoniazid; Mycobacterium tuberculosis; Polymorphism, Restriction Fragment Length; Rifampin; Streptomycin; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary

Topics: Antitubercular Agents; Chronic Disease; Drug Resistance; Fever; Humans; Intestinal Absorption; Isoniazid; Male; Middle Aged; Pyrazinamide; Rifampin; Tuberculosis, Pulmonary

We describe a patient with drug-resistant chronic tuberculous empyema in whom substantial differences between achievable pleural fluid and serum drug concentrations were displayed. The ratio of maximum concentration in pleural fluid to serum was especially low for rifampin (4%) but was also low for streptomycin (34%) and ofloxacin (48%). Subtherapeutic drug concentrations in the pleural fluid may have contributed to acquisition of drug resistance in this case.

Topics: Aged; Antitubercular Agents; Chronic Disease; Empyema, Tuberculous; Ethambutol; Humans; Male; Ofloxacin; Pleural Effusion; Rifampin; Streptomycin; Tuberculosis, Multidrug-Resistant

Chronic Q fever has been associated with endocarditis, granulomatous hepatitis, and osteomyelitis but only rarely with pregnancy. The apparent predilection of Coxiella burnetii, the organism causing Q fever, for the human placenta suggests that chronic Q fever of pregnancy is due to placentitis. We describe a patient with chronic, clinically apparent Q fever in pregnancy and a successful outcome. The diagnosis was made both by serology and by isolation of C. burnetii from the patient's serum and placenta. Therapy with erythromycin and rifampin contributed to the delivery of a healthy baby. The mother's infection was clinically cured by subsequent therapy with doxycycline and rifampin.

Topics: Adult; Antibodies, Bacterial; Chronic Disease; Coxiella burnetii; DNA, Bacterial; Drug Therapy, Combination; Erythromycin; Female; Humans; Infant, Newborn; Male; Placenta; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Q Fever; Rifampin

Rifametoprim (600 mg/day) was given to 64 patients with acute bacterial pneumonia, acute bronchitis and exacerbation of chronic bronchitis. 201 (83.4%) out of 241 isolates were sensitive to the action of the antibiotic. The treatment turned out effective in 84.4% of cases.

Topics: Acute Disease; Bacteria; Bronchitis; Capsules; Chronic Disease; Drug Combinations; Drug Evaluation; Humans; Microbial Sensitivity Tests; Pneumonia; Remission Induction; Rifampin; Sputum; Trimethoprim

Rifamethoprim is a new formulation containing rifampicin and trimethoprim. Its efficacy was studied in the treatment of a group of patients with various nonspecific diseases of the lungs. It was shown to be highly active against a broad spectrum of pathogens. With inclusion of trimethoprim to the formulation it appeared possible to markedly lower the bacterial ability to develop resistance to rifampicin, which solved the problem of long-term antibiotic use. The unique pharmacokinetic properties of rifampicin such as its capacity to penetrating into the sputum, lung tissues and cells make rifamethoprim be the drug of optimal choice in the treatment of respiratory diseases.

Topics: Acute Disease; Anti-Bacterial Agents; Bronchial Diseases; Chronic Disease; Drug Combinations; Drug Therapy, Combination; Humans; Lung Diseases; Rifampin; Trimethoprim

We compared the efficacy of a long-duration (3-week) therapy of vancomycin, fleroxacin, fleroxacin plus rifampin, and vancomycin plus fleroxacin and rifampin in a recently developed rat model of chronic staphylococcal foreign-body infection. Subcutaneous tissue cages containing polymethylmethacrylate coverslips were infected with 1 x 10(5) to 5 x 10(5) CFU of methicillin-resistant Staphylococcus aureus. Three weeks later, a quantitative culturing of the fluid that had accumulated in the cages was done (mean, 6.72 log10 CFU/ml; n = 110) and treatment was initiated after randomization. The CFUs in the cage fluid were counted on days 11 and 22 and 1 week after the termination of treatment; in addition, a final culture of coverslips (surface-bound microorganisms) was performed. The three-drug therapy was significantly superior to the other treatments on day 11 (a 5.16 log10 decrease of bacterial counts versus a 2.12 log10 to 2.94 log10 decrease for vancomycin, fleroxacin, and fleroxacin plus rifampin; P less than 0.01). On day 22, count decreases were 4.16 log10 for vancomycin, 4.91 log10 for fleroxacin (vancomycin versus fleroxacin, not significant), 6.14 log10 for two-drug therapy, and 6.34 log10 for three-drug therapy (vancomycin-fleroxacin-rifampin versus fleroxacin-rifampin, not significant; fleroxacin-rifampin versus monotherapies, P less than 0.01); the numbers of CFU in most cage fluids were under the detection limit (20 CFU/ml) in combination groups. One week after the end of treatment, 92% of fluids and coverslips (detection limit, 1 CFU) were culture negative with tritherapy, 88% of fluids and 41% of coverslips were negative with bitherapy, and less than 12% of fluids and coverslips were negative with single drugs (for coverslips, P was <0.01 for vancomycin-fleroxacin-rifampin versus fleroxacin-rifampin and P was <0.001 for fleroxacin-rifampin versus the monotherapies). No mutants resistant to rifampin or fleroxacin were detected. In conclusion, antimicrobial combinations were highly effective and superior to single drugs in treating a chronic staphylococcal foreign-body infection for 3 weeks. The three-drug therapy decreased bacterial counts more rapidly than the two-drug therapy under study and appeared to be curative in most cases.

Topics: Animals; Cells, Cultured; Chronic Disease; Drug Interactions; Drug Therapy, Combination; Fleroxacin; Foreign-Body Reaction; Methicillin Resistance; Microbial Sensitivity Tests; Rats; Rats, Inbred Strains; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Vancomycin

The efficacy of treatment with rifampicin-dimexide++ aerosols of 184 pulmonary tuberculosis patients and 18 chronic obstructive bronchitis patients was studied. The character of the residual changes following the main chemotherapeutic course was studied in 98 patients. Dimexide++ was proved to be a good rifampicin solvent and synergist enhancing its bacteriostatic action. Rifampicin used in a dose of 150-300 mg in 3-4 ml of dimexide++ in aerosols for 1-2 months promotes bacillary excretion cessation and healing of destruction cavities and allows for a reduction of its toxic action on liver parenchyma. Rifampicin--dimexide++ aerosols contribute to more complete tuberculosis cure and reduce the residual pulmonary and bronchial changes. Rifampicin with dimexide++ can be successfully used for treating chronic bronchitis both as an independent disease and concurrent disease in pulmonary tuberculosis.

Topics: Administration, Inhalation; Adolescent; Adult; Aged; Bronchitis; Chronic Disease; Dimethyl Sulfoxide; Drug Combinations; Drug Synergism; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

The efficacies of the quinolones ciprofloxacin and pefloxacin alone and in combination with rifampin were compared with those of vancomycin alone and in combination with rifampin in a rat model of chronic osteomyelitis caused by methicillin-resistant Staphylococcus aureus. Neither the quinolones nor vancomycin alone was effective in reducing titers of organisms in bone after therapy, while rifampin alone was effective. All combination regimens with rifampin were more effective than the regimen with rifampin alone was, although these differences did not achieve statistical significance. Rifampin-resistant isolates were detected rarely. Quinolone-rifampin combination regimens may offer a nonparenteral option for the treatment of chronic osteomyelitis caused by methicillin-resistant S. aureus.

Topics: Animals; Chronic Disease; Ciprofloxacin; Disease Models, Animal; Drug Therapy, Combination; Male; Methicillin; Osteomyelitis; Pefloxacin; Penicillin Resistance; Rats; Rats, Inbred Strains; Rifampin; Staphylococcal Infections; Vancomycin

Therapeutic effect of liposomal dosages of rifampicin and prodigiozan was studied on rabbits with simulated chronic tonsillitis in comparison to that of commercial ones of the drugs. The treatment schemes included daily intra-tonsillar++ injections of the dosage forms for 5 days. A high efficacy of their liposomal dosage forms in treatment of experimental chronic tonsillitis was confirmed microbiologically and immunologically. Approval of the liposomal dosage forms used in the therapy of patients with chronic tonsillitis requires clinical trials.

Topics: Adjuvants, Immunologic; Animals; Chronic Disease; Drug Carriers; Drug Evaluation, Preclinical; Drug Therapy, Combination; Liposomes; Palatine Tonsil; Polysaccharides, Bacterial; Prodigiozan; Rabbits; Rifampin; Streptococcal Infections; Tonsillitis

Chronic orbital inflammatory disease (COID) is usually considered non-infectious and idiopathic. Treatment is empirical, palliative, and may not prevent disease progression. COID occurs in isolation or in association with various systemic diseases. Exophthalmos may be an important presenting sign. Vasculitis, lymphoid infiltrates, and granulomas are common. Mollicute-like organisms (MLO) parasitising and destroying vitreous leucocytes are often found to cause human chronic uveitis when an appropriate search is made. Inoculation of these MLO into mouse eyelids produced chronic uveitis and exophthalmic orbital inflammatory disease. Mollicutes are cell wall deficient bacteria. Extracellular mollicutes cause human and animal diseases characterised by lymphoid infiltrates, immunosuppression, and autoantibody production. Intracellular morphologically similar bacteria are non-cultivable pathogens termed MLO. Identification is based on direct detection in diseased cells by transmission electron microscopy. MLO are cytopathogenic and detection is aided by the alterations they produce. MLO replace the cytoplasm, destroy the organelles, and alter the nucleus. This results in cell proliferation, destruction, and dysfunction. MLO parasitise lymphocytes, monocytes, and polymorphonuclear leucocytes. This report describes orbital leucocytes parasitised by MLO in three patients with isolated COID. Rifampicin treatment of MLO disease is discussed.

Topics: Adolescent; Aged; Bacterial Infections; Chronic Disease; Female; Humans; Inflammation; Leukocytes; Microscopy, Electron; Middle Aged; Mycoplasmatales Infections; Orbital Diseases; Rifampin

Topics: Adolescent; Adult; Chronic Disease; Doxycycline; Drug Evaluation; Drug Therapy, Combination; Female; Fusidic Acid; Gonorrhea; Humans; Male; Middle Aged; Recurrence; Rifampin; Staphylococcal Toxoid

Topics: Adult; Bronchitis; Chronic Disease; Drug Interactions; Drug Therapy, Combination; Dyphylline; Erythromycin; Humans; Lincomycin; Male; Middle Aged; Rifampin; Theophylline

Topics: Adolescent; Adult; Aged; Bronchitis; Chronic Disease; Drug Evaluation; Female; Humans; Male; Middle Aged; Pulmonary Heart Disease; Rifampin; Streptomycin; Time Factors

Topics: Adult; Animals; Chronic Disease; Drug Resistance, Microbial; Guinea Pigs; Humans; Isoniazid; Middle Aged; Mycobacterium tuberculosis; Rifampin; Time Factors; Tuberculosis, Pulmonary; Virulence

Topics: China; Chronic Disease; Developing Countries; Humans; India; Isoniazid; Netherlands; Patient Compliance; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Seventy out-patients suffering from chronic bacterial prostatitis were treated with a combination of trimethoprim plus rifampicin or trimethoprim alone. A combination of 300 mg. rifampicin plus 160 mg. trimethoprim (rifaprim) was used. Forty-four patients were administered rifaprim at doses of 920 mg. (twice a day) for two months. Twenty-six patients were administered trimethoprim at doses of 320 mg. (twice a day) for two months. Cultures of the expressed prostatic secretions (EPS) yielded gram-positive bacteria in 61 patients and gram-negative bacteria in 9. In rifaprim group, clinical responses were excellent in 9 cases, moderate in 23 cases and poor in 12 cases. The efficacy rate was 73%. In trimethoprim group, excellent in 1 case, moderate in 14 cases and poor in 11 cases. The efficacy rate was 60%. Seven patients of chronic bacterial prostatitis were treated by local injection of tobramycin into the prostate. The antibiotic level in the prostatic fluid twenty-four hours after injection was very high. The pain and discomfort experienced by the patients during injection into the prostate were minimal. Local necrosis was not found after histologic or electron microscopic studies of biopsied prostatic specimen after the injection. Results show that this simple method should be valuable in the treatment of the refractory group of chronic bacterial prostatitis.

Topics: Adult; Bacterial Infections; Chronic Disease; Drug Combinations; Drug Evaluation; Drug Therapy, Combination; Humans; Injections; Male; Middle Aged; Prostate; Prostatitis; Rifampin; Tobramycin; Trimethoprim

Topics: Administration, Oral; Adult; Chronic Disease; Female; Humans; Infusions, Parenteral; Isoniazid; Kinetics; Male; Pulmonary Heart Disease; Rifampin; Streptomycin; Time Factors; Tuberculosis, Pulmonary

Topics: Adrenal Glands; Adult; Catecholamines; Chronic Disease; Ethambutol; Female; Humans; Male; Middle Aged; Recurrence; Rifampin; Sympathetic Nervous System; Tuberculosis, Pulmonary

Rifampin, which exhibits good intracellular diffusion and in vitro bactericidal activity on brucella, is effective in experimental brucellosis in mice, without selection of resistant strains. It was therefore legitimate to use rifampin in man since conventional treatment of acute brucellosis is followed by recurrence in 15% (tetracycline alone) or 3.7% (streptomycin-tetracycline combination) of cases. Rifampin was given to 13 patients with brucellosis (acute brucellosis in 8, osteoarticular brucellosis in 3 and chronic brucellosis in 2). Rifampin was given as sole therapy in a daily dosage of 600 to 1 200 mg. A tetracycline was subsequently needed in three cases, in combination with rifampin in two, and as replacement therapy in one. Treatment lasted 20 to 60 days in acute brucellosis and 2 to 15 months in other forms. Only one failure was recorded among the 11 cases of acute or localized brucellosis. Conversely, effectiveness of rifampin proved incomplete (1 case) or null (1 case) in chronic forms. The satisfactory effectiveness of rifampin is confirmed by a review of the literature which found 17 reports addressing the subject. These include 324 cases of brucellosis treated by rifampin, as sole therapy in 255 patients, with only 24 failures ascribable to faulty dosage. Indeed, rifampin must be given for at least 30 days, in a minimal daily dosage of 600 mg or 10 mg per kg, in a single dose. Cotrimoxazole is an antagonist and should not be associated with rifampin. Conversely, tetracyclines are synergistic and their association, which is useless in acute brucellosis, is helpful in localized and chronic forms.

Topics: Acute Disease; Adult; Aged; Bone Diseases; Brucellosis; Chronic Disease; Doxycycline; Drug Therapy, Combination; Female; Humans; Joint Diseases; Male; Middle Aged; Rifampin; Sepsis

Case report on a 40 years old patient with pulmonary tuberculosis, in whom a treatment with Rifampicin plus Ethambutol has caused a transient hepatic and renal failure. By histology a chronic aggressive hepatitis and a destruction of renal tubular epithelium could be found. The etiologic role of Rifampicin is believed to be probable. Pathomechanism and differential diagnosis are discussed.

Topics: Adult; Chronic Disease; Drug Therapy, Combination; Ethambutol; Hepatitis, Alcoholic; Humans; Kidney; Liver; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Chronic Disease; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

The effects of various chemotherapeutic regimens were investigated in ddY mice infected intravenously with a mouse-virulent strain, 31F093T, of Mycobacterium avium-intracellulare. Evaluation of therapeutic effects was based on serial counts of viable bacilli in the lung, the spleen, and the kidney, as well as on weight and extent of gross diseases of the organs, and on histopathologic examination. Kanamycin alone was effective against the infection. The combination of ethambutol and rifampin with kanamycin (KM-EMB-RMP) decreased counts in the lung. In another 3-drug regimen (kanamycin, ethionamide, and cycloserine), the effect was similar. Two 4-drug regimens, KM-EMB-RMP-CEX and KM-EMB-RMP-MINO, as well as a 5-drug regimen, KM-EMB-RMP-CS-INH, were also compared with the above 3-drug regimens, and only the 5-drug regimen decreased counts in the lung more than the 3-drug regimens did. Even the 5-drug regimen, however, could not eradicate the mycobacteria in the organs of mice, which demonstrates the inveteracy of M. avium-intracellulare infection. The control mice consistently showed grossly visible disease of the lung at 6 wk of infection, and the histopathologic findings were granuloma (3 to 6 wk of infection) and diffuse proliferative change beyond 9 weeks of infection, which was persistent and slowly progressive. The spleens and livers showed extensive granulomatous changes. The subacuteness of grossly visible lung disease with significant multiplication of bacilli in the organ of the control mice in the present murine model should prove useful in evaluating experimental chemotherapy of M. avium-intracellulare infection.

Topics: Animals; Antitubercular Agents; Chronic Disease; Cycloserine; Disease Models, Animal; Drug Therapy, Combination; Ethambutol; Kanamycin; Liver; Lung; Male; Mice; Mycobacterium avium; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Rifampin; Spleen; Time Factors

An evolution analysis of tuberculosis management includes four essential times. The first time coincides with the streptomycin therapeutic employment; the second develops with isoniazid disposing; the third time takes in the period of identification of several drugs a long time called "minor", but very important to formulate some "ad personam" therapeutic patterns. At last, the fourth time is characterized by formulation of short-course chemotherapy. Now the suggested protocol is a regimen of short-course chemotherapy with daily administration of INH and RIF for six-nine months with an initial supplement of ethambutol, or streptomycin or pyrazinamide for the first two months.

Topics: Ambulatory Care; Chronic Disease; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Ethambutol; Hospitalization; Humans; Isoniazid; Patient Compliance; Rifampin; Time Factors; Tuberculosis, Pulmonary

Vancomycin was used alone and in combination with rifampin in the treatment of experimental osteomyelitis due to Staphylococcus aureus in rabbits. Treatment with 60 mg of vancomycin/kg of body weight twice a day for 28 days was ineffective in sterilizing infected rabbit bones. Rifampin (40 mg/kg) injected once a day for 28 days sterilized 57% of infected rabbit bones. Treatment with a combination of vancomycin and rifampin for either 14 or 28 days was significantly more effective than either drug used alone, sterilizing 84% and 90%, respectively, of the infected bones of treated animals. A possible explanation for the failure of vancomycin when used alone may be that its in vitro activity against the infecting strain of S. aureus (as measured by minimal inhibitory concentrations or minimal bactericidal concentrations) was substantially less under anaerobic conditions (that is, at partial pressures of oxygen analogous to those in osteomyelitic bones) than under aerobic conditions.

Topics: Animals; Chronic Disease; Drug Therapy, Combination; Female; Microbial Sensitivity Tests; Osteomyelitis; Rabbits; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Vancomycin

Rifampicin plus trimethoprim (rifaprim) was used to treat 20 patients with chronic prostatitis in exacerbation: 11 received 2 tablets at bedtime for 15 days followed by 1 tablet at bedtime for another 105 days, and 9 received 1 tablet in the morning and 2 tablets at bedtime for 15 days, then 2 tablets at bedtime for 15 days followed by 1 tablet at bedtime for another 90 days. All patients had an enlarged tender prostate and all but 2 were symptomatic. In 10 patients previous treatment, including co-trimoxazole in 5, had failed. Cultures of the expressed prostatic secretions yielded Staphylococcus aureus in 17 patients and gram-negative micro-organisms in 3. At the end of treatment 6 of 11 patients given the lower dosage were cured clinically and bacteriologically compared to 8 of 9 given the higher dosage. After 2 to 3 years of following 5 of 9 patients in the first group and all 7 in the second group had not suffered relapse. From our study it is evident that rifaprim is a potent drug in the treatment of chronic prostatitis caused mainly by Staphylococcus aureus. A promptness of therapeutic response and the rate of cure at the end of treatment as well as after at least 2 years of followup favor the higher drug dosage.

Topics: Adult; Chronic Disease; Drug Combinations; Humans; Male; Middle Aged; Prostatitis; Rifampin; Staphylococcal Infections; Trimethoprim

Topics: Adult; Chronic Disease; Drug Evaluation; Drug Therapy, Combination; Ethambutol; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Chronic Disease; Cytoplasmic Granules; Doxycycline; Furunculosis; Humans; Neutrophils; Pyoderma; Recurrence; Rifampin; Time Factors

Topics: Adult; Aged; Chronic Disease; Female; Humans; Male; Middle Aged; Rifampin; Trimethoprim; Urinary Tract Infections

Penetration of benemycin (rifampicin) into the prostate secretion and ejaculate of patients with chronic bacterial prostatitis was studied. It was found that oral administration of the drug in a dose of 300 mg 2 times a day provided bacteriostatic concentrations of the antibiotic in the sexual gland excretions and the treatment efficacy of patients with prostatitis.

Topics: Chronic Disease; Ejaculation; Humans; Male; Prostate; Prostatitis; Rifampin; Time Factors; Tissue Distribution

Topics: Chronic Disease; Drug Evaluation; Drug Therapy, Combination; Drug Tolerance; Ethambutol; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Four cases of chronic granulomatous skin infections (two due to Sporothrix schenckii and two to Mycobacterium marinum) were treated primarily by the intermittent application of local hyperthermia. This treatment was initiated either because of intolerance to conventional iodide therapy for sporotrichosis or as interim therapy while awaiting diagnosis of the mycobacterial infections. The response indicated that the application of heat is a useful adjunct to the therapy of these infections. Our experience, and that of others, suggests that in some cases heat alone may be curative.

Topics: Adult; Aged; Chronic Disease; Ethambutol; Female; Granuloma; Hot Temperature; Humans; Iodides; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Rifampin; Skin Diseases, Infectious; Sporotrichosis

Topics: Antitubercular Agents; Chronic Disease; Drug Therapy, Combination; Humans; Rifampin; Tuberculosis, Pulmonary

Because the accumulation of macrophages and their precursors, peripheral blood monocytes, in foci of infection is an important feature of the host reponse to mycobacterial challenge, the leukotactic responsiveness of monocytes from patients with active tuberculosis was evaluated. With a double-filter, in vitro technique, defective leukotaxis was demonstrated in monocytes from 19 of 20 untreated patients, whereas normal leukotactic responses were found in monocytes from 11 of 15 patients with chronic, nontuberculous pulmonary inflammatory diseases. This defect may be related to increased activity of a naturally occurring, heat-stable plasma substance with a molecular mass of approximately 2.3 x 10(5) daltons that inhibited leukotactic responsiveness. Monocyte leukotaxis improved and the leukotactic inhibitory activity of plasma disappeared in most patients while they were on therapy; these phenomena were unrelated to bacteriologic conversion or resolution of symptoms. In vitro studies with isoniazid, ethambutol, and rifampin excluded a direct effect of these drugs or their metabolites on monocytes or on the leukotactic inhibitor in plasma. Thus, defective leukotaxis of monocytes in patients with pulmonary tuberculosis may be an epiphenomenon of the local tissue reaction.

Topics: Adolescent; Adult; Aged; Chemotaxis, Leukocyte; Chronic Disease; Dose-Response Relationship, Immunologic; Ethambutol; Female; Humans; Immunity, Cellular; In Vitro Techniques; Isoniazid; Lung Diseases; Lymphokines; Male; Middle Aged; Monocytes; Rifampin; Tuberculosis, Pulmonary; Zymosan

Topics: Adolescent; Adult; Antitubercular Agents; Chronic Disease; Ethambutol; Humans; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Antitubercular Agents; Chronic Disease; Drug Therapy, Combination; Female; Hospitalization; Humans; Male; Middle Aged; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Chronic Disease; Drug Therapy, Combination; Ethambutol; Follow-Up Studies; Humans; Rifampin; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Ambulatory Care; Chronic Disease; Drug Therapy, Combination; Ethambutol; Humans; Middle Aged; Rifampin; Rural Population; Tuberculosis, Pulmonary; Uzbekistan

Studies on the chemotherapeutic action of rifampicin in treatment of staphylococcal sepsis and sepsis caused by gramnegative organisms showed its high efficacy only in treatment of the staphylococcal infection. By the level of its efficacy rifampicin was much superior to benzylpenicillin and especially tetracycline. No difference in the activity level of the antibiotic in treatment of staphylococcal infections caused by sensitive and multiple resistant staphylococcal strains was found. In treatment of the infections caused by gramnegative organisms the drug activity was moderate.

Topics: Acute Disease; Animals; Bacterial Infections; Chronic Disease; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Escherichia coli Infections; Mice; Moscow; Proteus Infections; Pseudomonas Infections; Rifampin; Staphylococcal Infections

Topics: Adult; Aged; Chronic Disease; Drug Therapy, Combination; Ethambutol; Female; Humans; Male; Middle Aged; Mycobacterium tuberculosis; Rifampin; Sputum; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Chronic Disease; Drug Evaluation; Drug Therapy, Combination; Ethambutol; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Antitubercular Agents; Chronic Disease; Drug Evaluation; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Rifampin; Tuberculosis, Pulmonary

Topics: Acetylcholine; Alanine Transaminase; Alkaline Phosphatase; Blood Proteins; Carbohydrate Metabolism; Cholinesterases; Chronic Disease; Ethambutol; Humans; Liver; Rifampin; Tuberculosis, Pulmonary

Report on a 24 years old first pregnant woman with chronic pyelonephritis, treated for 1 1/2 years, also during pregnancy, with high doses of rifampicin (1200 mgs/day). After normal delivery in the 42 th. week of pregnancy there were bleedings both in mother and newborn with demonstrable temporary disturbances in liver-function and coagulation system. Especially the coagulation factors produced in the liver were concerned. The complications after rifampicin carried out the conclusion that rifampicin should be given in pregnancy only with exact indication.

Topics: Blood Coagulation Disorders; Chemical and Drug Induced Liver Injury; Chronic Disease; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Pregnancy Complications, Infectious; Pyelonephritis; Rifampin

Topics: Chronic Disease; Drug Therapy, Combination; Ethambutol; Follow-Up Studies; Humans; Poland; Recurrence; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Disease; Adult; Chronic Disease; Gonorrhea; Humans; Male; Middle Aged; Rifampin

Benemecin, a Polish rifampicin was tested in vitro and clinically for the treatment of 2 groups of patients, i.e. 28 patients with chronic destructive tuberculosis of the lungs and 30 patients with non-specific pneumonia. High tuberculostatic activity of the drug in vitro was found. The clinical trials showed high efficiency of benemecin in the treatment of chronic destructive tuberculosis of the lungs and pneumonia of non-specific etiology. The drug was mainly well tolerated by the patients.

Topics: Chronic Disease; Drug Evaluation; Drug Resistance, Microbial; Drug Therapy, Combination; Ethambutol; Humans; Italy; Lung Diseases; Mycobacterium tuberculosis; Pneumonia; Poland; Postoperative Care; Rifampin; Time Factors; Tuberculosis, Pulmonary; Yugoslavia

Topics: Acute Kidney Injury; Adult; Aged; Anaphylaxis; Chronic Disease; Female; Humans; Male; Methods; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Antitubercular Agents; Chronic Disease; Ethambutol; Follow-Up Studies; Humans; Methods; Rifampin; Time Factors; Tuberculosis, Pulmonary

The authors study the influence of acute and chronic ethanol intoxication on the blood levels of rifampicin and isoniazid as well of aminoglycoside antibiotics in rats. While the acute ethanol intoxication has no influence on blood levels of tested antibiotics, in the chronic inotoxication lower levels of rifampicin and higher levels of isoniazid are observed. A study was performed also to determine the influence of an acute and chronic treatment with alcohol and the avoe quoted antibiotics on the BSP elimination rate. In the acute as well as in the chronic experiments, a constant significant delay in the elimination of BSP was observed in animals treated with rafampicin either alone or associated with alcohol. Isoniazid modified the dye elimination in comparison to controls only in chronic experiments. Ethanol did not seem to have any influence on this behavior. The implications and the possible significance of these findings are discussed.

Topics: Acute Disease; Alcoholic Intoxication; Animals; Anti-Bacterial Agents; Chronic Disease; Drug Interactions; Ethanol; Gentamicins; Humans; Isoniazid; Kanamycin; Liver; Male; Rats; Rifampin; Streptomycin; Sulfobromophthalein

Topics: Aminosalicylic Acids; Chronic Disease; Congresses as Topic; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Male; Poland; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Topics: Chronic Disease; Cycloserine; Drug Resistance, Microbial; Humans; Postoperative Care; Rifampin; Sputum; Tuberculosis, Pulmonary; Viomycin

Topics: Adult; Antitubercular Agents; Chronic Disease; Cycloserine; Drug Evaluation; Ethambutol; Ethionamide; Female; Hospitals, Special; Humans; Kanamycin; Male; Middle Aged; Pyrazinamide; Rifampin; Thiosemicarbazones; Tuberculosis, Pulmonary; Viomycin

Topics: Ampicillin; Anti-Bacterial Agents; Chenodeoxycholic Acid; Cholecystitis; Chronic Disease; Humans; Novobiocin; Parasympatholytics; Penicillins; Peptides; Rifampin

Topics: Adolescent; Adult; Aged; Chronic Disease; Drug Evaluation; Ethambutol; Female; Humans; Male; Middle Aged; Radiography; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Antitubercular Agents; Chronic Disease; Drug Evaluation; Drug Synergism; Drug Therapy, Combination; Ethambutol; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Chronic Disease; Drug Therapy, Combination; Ethambutol; Humans; Occupational Medicine; Railroads; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Chronic Disease; Drug Therapy, Combination; Ethambutol; Humans; Middle Aged; Rifampin; Sputum; Tuberculosis, Pulmonary

Topics: Adult; Aged; Chronic Disease; Female; Humans; Male; Methods; Middle Aged; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Adult; Aged; Chronic Disease; Drug Therapy, Combination; Ethambutol; Female; Humans; Male; Methods; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Chronic Disease; Ethambutol; Humans; Middle Aged; Rifampin; Sputum; Time Factors; Tuberculosis, Pulmonary

Topics: Abnormalities, Drug-Induced; Animals; Child; Child, Preschool; Chronic Disease; Drug Therapy, Combination; Ethambutol; Female; Fetus; Follow-Up Studies; Growth; Humans; Infant; Infant, Newborn; Isoniazid; Mice; Pregnancy; Pregnancy Complications, Infectious; Rabbits; Rats; Rifampin; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Chronic Disease; Drug Combinations; Ethambutol; Female; Humans; Male; Middle Aged; Patient Dropouts; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Animals; Chronic Disease; Drug Therapy, Combination; Female; Isoniazid; Lung; Mice; Mycobacterium bovis; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Adult; Antitubercular Agents; Chronic Disease; Drug Synergism; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Adult; Aged; Antitubercular Agents; Chronic Disease; Drug Combinations; Female; Humans; Hungary; Male; Middle Aged; Rifampin; Tuberculosis

Topics: Acute Kidney Injury; Chronic Disease; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Chronic Disease; Drug Evaluation; Drug Resistance, Microbial; Drug Therapy, Combination; Ethambutol; Humans; Rifampin; Sputum; Time Factors; Tuberculosis, Pulmonary

Topics: Chronic Disease; Hematopoietic System; Humans; Kidney; Liver; Lung; Methods; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Adult; Aged; Alanine Transaminase; Aspartate Aminotransferases; Chronic Disease; Drug Therapy, Combination; Eosinophilia; Ethambutol; Female; Gastrointestinal Diseases; Humans; Kidney; Liver; Male; Mental Disorders; Middle Aged; Radiography; Rifampin; Sputum; Tuberculosis, Pulmonary; Vertigo; Vision Disorders

Topics: Chronic Disease; Drug Combinations; Drug Resistance, Microbial; Evaluation Studies as Topic; History, 16th Century; Lung; Rifampin; Sputum; Tuberculosis, Pulmonary

Topics: Acute Disease; Bacteria; Chronic Disease; Drug Resistance, Microbial; Enterobacteriaceae; Humans; Pseudomonas; Rifampin; Urinary Tract Infections

Topics: Administration, Oral; Adult; Antifungal Agents; Antitubercular Agents; Aspergillosis; Benzene Derivatives; Bronchial Fistula; Chronic Disease; Female; Humans; Imidazoles; Lung Diseases, Fungal; Pneumothorax; Radiography; Rifampin; Tuberculosis, Pulmonary

Topics: Chronic Disease; Ethambutol; Evaluation Studies as Topic; Follow-Up Studies; Humans; Rifampin; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Antitubercular Agents; Chronic Disease; Drug Combinations; Ethambutol; Evaluation Studies as Topic; Female; Humans; Isoniazid; Male; Middle Aged; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Topics: Alcoholism; Aspartate Aminotransferases; Bilirubin; Chronic Disease; Ethambutol; Humans; Liver Cirrhosis; Male; Melena; Middle Aged; Recurrence; Rifampin; Sputum; Thrombocytopenia; Tuberculosis, Pulmonary

Topics: Alcoholism; Chronic Disease; Humans; Liver Cirrhosis; Male; Middle Aged; Rifampin; Thrombocytopenia; Tuberculosis

Topics: Antitubercular Agents; Chronic Disease; Drug Synergism; Female; Humans; Male; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Antitubercular Agents; Chronic Disease; Ethambutol; Humans; Isoniazid; Rifampin; Tuberculosis, Pulmonary

Topics: Antitubercular Agents; Chronic Disease; Ethambutol; Hepatitis; Humans; Liver Diseases; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Topics: Aminosalicylic Acids; Chronic Disease; Cycloserine; Drug Resistance, Microbial; Ethambutol; Ethionamide; Humans; Isoniazid; Microbial Sensitivity Tests; Pyrazinamide; Rifampin; Sputum; Streptomycin; Tuberculosis, Pulmonary

Topics: Adult; Chronic Disease; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Chronic Disease; Drug Synergism; Ethambutol; Evaluation Studies as Topic; Humans; Rifampin; Tuberculosis, Pulmonary

Topics: Alanine Transaminase; Alcoholism; Aspartate Aminotransferases; Bilirubin; Biopsy; Chronic Disease; Drug Combinations; Follow-Up Studies; Humans; Jaundice; Liver; Liver Diseases; Liver Function Tests; Radiography; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Adult; Aged; Chronic Disease; Drug Combinations; Drug Resistance, Microbial; Ethambutol; Female; Humans; Liver Cirrhosis; Liver Diseases; Male; Middle Aged; Rifampin; Sputum; Tuberculosis, Pulmonary

Topics: Adult; Chronic Disease; Drug Combinations; Drug Resistance, Microbial; Ethambutol; Female; Humans; Male; Middle Aged; Pneumoconiosis; Pulmonary Fibrosis; Rifampin; Sputum; Time Factors; Tuberculosis, Pulmonary

Topics: Adult; Chronic Disease; Drug Resistance, Microbial; Female; Humans; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Chronic Disease; Ethambutol; Humans; Rifampin; Tuberculosis, Pulmonary

Topics: Animals; Cell Count; Chronic Disease; Disease Models, Animal; Drug Synergism; Ethambutol; Ethionamide; Isoniazid; Lung; Mice; Placebos; Rifampin; Streptomycin; Tuberculosis

Topics: Administration, Oral; Chronic Disease; Humans; Rifampin; Tuberculosis

Topics: Chronic Disease; Drug Synergism; Ethambutol; Humans; Rifampin; Tuberculosis, Pulmonary

Topics: Bone Marrow; Chronic Disease; gamma-Globulins; Humans; Immunoelectrophoresis; Liver; Pyelonephritis; Rifampin

Topics: Administration, Oral; Adult; Aged; Capreomycin; Chronic Disease; Drug Combinations; Ethambutol; Female; Humans; Kanamycin; Lung; Male; Middle Aged; Mycobacterium tuberculosis; Oxytetracycline; Pyrazinamide; Radiography; Rifampin; Sputum; Time Factors; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Bacteriuria; Cephalothin; Chloramphenicol; Chronic Disease; Colistin; Drug Resistance, Microbial; Escherichia coli Infections; Female; Gentamicins; Humans; Kanamycin; Male; Methacycline; Middle Aged; Oxytetracycline; Proteus Infections; Rifampin; Sulfamethoxypyridazine; Urinary Tract Infections

Topics: Acute Disease; Adult; Chronic Disease; Escherichia coli Infections; Female; Humans; Male; Middle Aged; Proteus Infections; Pseudomonas Infections; Rifampin; Staphylococcal Infections; Urinary Tract Infections; Urologic Diseases

Topics: Adolescent; Adult; Aerosols; Ampicillin; Anti-Bacterial Agents; Bacteria; Child; Chronic Disease; Depression, Chemical; Erythromycin; Erythromycin Ethylsuccinate; Humans; Injections, Intramuscular; Iontophoresis; Methacycline; Methicillin; Middle Aged; Neomycin; Oleandomycin; Oxacillin; Palatine Tonsil; Penicillin Resistance; Rifampin; Saliva; Staphylococcus; Streptococcus; Tetracycline; Time Factors; Tonsillitis

Topics: Acute Disease; Adolescent; Adult; Aged; Chronic Disease; Cystitis; Female; Humans; Male; Middle Aged; Prostatitis; Pyelitis; Pyelonephritis; Rifampin; Semen; Urinary Tract Infections

Topics: Adult; Aged; Antitubercular Agents; Chemical Phenomena; Chemistry; Chronic Disease; Drug Resistance, Microbial; Drug Synergism; Female; Humans; In Vitro Techniques; Male; Middle Aged; Mycobacterium tuberculosis; Rifampin; Sputum; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Disease; Administration, Oral; Animals; Atrophy; Body Weight; Chronic Disease; Female; Injections, Intraperitoneal; Injections, Subcutaneous; Male; Mice; Organ Size; Piperidines; Rats; Rifampin; Sex Factors; Testis

Topics: Administration, Oral; Chronic Disease; Humans; Intestinal Absorption; Kidney Diseases; Kidney Failure, Chronic; Peritoneal Dialysis; Renal Dialysis; Rifampin

Topics: Aged; Alcoholism; Bronchial Neoplasms; Chronic Disease; Diabetes Mellitus; Eczema; Evaluation Studies as Topic; Humans; Male; Middle Aged; Radiography; Rifampin; Tuberculosis, Pulmonary

Topics: Aminosalicylic Acids; Chronic Disease; Drug Combinations; Ethambutol; Humans; Pyrazinamide; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Disease; Chronic Disease; Evaluation Studies as Topic; Humans; Periodontal Diseases; Rifampin

Topics: Chronic Disease; Cycloserine; Drug Combinations; Ethambutol; Ethionamide; Humans; Phenylthiourea; Pyrazinamide; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Chronic Disease; Humans; Infections; Nitrogen; Pneumococcal Infections; Respiratory Tract Infections; Rifampin; Staphylococcal Infections; Tuberculosis, Pulmonary; Urinary Tract Infections

Topics: Bronchitis; Chronic Disease; Humans; Rifampin; Sputum

Topics: Bronchitis; Chronic Disease; Drug Resistance, Microbial; Drug Synergism; Economics, Medical; Ethambutol; Humans; Isoniazid; Rifampin; Tuberculosis

Topics: Chronic Disease; Coma; Dactinomycin; Daunorubicin; Dexamethasone; Encephalomyelitis; Fever; Headache; Humans; Idoxuridine; Leukopenia; Meningitis, Viral; Mental Disorders; Pain; Paralysis; Respiratory Insufficiency; Rifampin; Vomiting

Topics: Adult; Aged; Bronchiectasis; Bronchitis; Chronic Disease; Endocarditis, Bacterial; Female; Humans; Male; Middle Aged; Osteomyelitis; Rifampin

Topics: Antitubercular Agents; Chronic Disease; Drug Synergism; Ethambutol; Humans; Rifampin; Tuberculosis, Pulmonary

Topics: Anti-Bacterial Agents; Antitubercular Agents; Chronic Disease; Drug Resistance, Microbial; Ethambutol; Female; Humans; Microbial Sensitivity Tests; Peptides; Rifampin; Tuberculosis, Urogenital

Topics: Adult; Anti-Bacterial Agents; Antitubercular Agents; Chronic Disease; Drug Synergism; Ethambutol; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Chronic Disease; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Mycobacterium tuberculosis; Rifampin; Sputum; Time Factors; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aminosalicylic Acids; Chronic Disease; Drug Synergism; Female; Humans; Male; Middle Aged; Radiography; Rifampin; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aminosalicylic Acids; Chronic Disease; Ethambutol; Humans; Male; Middle Aged; Radiography; Rifampin; Time Factors; Tuberculosis, Lymph Node; Tuberculosis, Miliary; Tuberculosis, Pulmonary

Topics: Adult; Chronic Disease; Female; Humans; Male; Middle Aged; Radiography; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Antitubercular Agents; Chronic Disease; Drug Resistance, Microbial; Humans; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Ambulatory Care; Chronic Disease; Female; Humans; Male; Radiography; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Disease; Adult; Aged; Chronic Disease; Humans; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Aminosalicylic Acids; Antitubercular Agents; Chronic Disease; Cycloserine; Empyema, Tuberculous; Ethambutol; Humans; Isonicotinic Acids; Kidney Function Tests; Liver Function Tests; Lung Diseases; Middle Aged; Morpholines; Pyrazines; Rifampin; Tuberculosis, Miliary; Tuberculosis, Pulmonary

Topics: Acetylcholine; Adult; Aged; Arteriosclerosis; Chronic Disease; Humans; Injections, Intra-Arterial; Middle Aged; Osteomyelitis; Rifampin