rifampin and Drug-Hypersensitivity

True hypersensitivity reactions to rifampicin are relatively rare, nonetheless severe manifestations mostly involving a single organ have been documented. We report a case of acute multi-organ failure occurring after a medication error with re-exposure to rifampicin.. A 68-year old patient developed acute hypersensitivity pneumonitis, acute renal failure, acute liver failure and haemolytic anemia within hours after a second re-exposure to Rifampicin for the treatment of a hip prosthesis infection with Staphylococcus epidermidis. A recent rifampicin exposure 1 week earlier had resulted in a massive rise of CRP levels without organ manifestations. Nine years previously, the patient had developed a multi-organ hypersensitivity reaction 8 days after commencing treatment with rifampicin for pulmonary tuberculosis; and 23 years previously he had received rifampicin without problems. The organ-specific hypersensitivity reactions were largely reversible after withdrawal of rifampicin and treatment with steroids. A review of the literature and summary of WHO spontaneous safety reports is also given.. Re-exposure to rifampicin in sensitised individuals may cause acute severe hypersensitivity reactions. Due to its indications in the management of mycobacterial and implant-associated infections, rifampicin is a drug which might be given decades apart, which poses a risk that information about previous intolerance is lost.

Topics: Aged; Antibiotics, Antitubercular; Drug Hypersensitivity; Humans; Male; Multiple Organ Failure; Rifampin

Drug hypersensitivity reactions can occur to almost all drugs and antibiotics are among the most common cause for this kind of reactions. Drug hypersensitivity may affect any organ or system, and manifestations range widely in clinical severity from mild pruritus to anaphylaxis. In most cases, the suspected drug is avoided in the future. In case of infection, there is usually a safe antibiotic alternative. Nonetheless, in some cases, no alternative treatment exists for optimal therapy. Under these circumstances, desensitization may be performed. Drug desensitization is defined as the induction of a temporary state of tolerance to a drug which can only be maintained by continuous administration of the medication responsible for the hypersensitivity reaction. Desensitization is mainly performed in IgE-mediated reactions. Increasing doses of the implicated drug are administered over a short period of time, until the therapeutic dose is achieved and tolerated. Very few studies confined to children are found in literature. Most of them are case reports. In general, the proposed desensitization schemes are similar to those used in adults differing only in the final dose administered. The purpose of this study is to review desensitization to antibiotics in children presenting and discussing three clinical practical cases of desensitization in this age group.

Topics: Adult; Anti-Bacterial Agents; Ceftazidime; Child; Child, Preschool; Desensitization, Immunologic; Drug Administration Schedule; Drug Hypersensitivity; Female; Humans; Immune Tolerance; Immunoglobulin E; Male; Penicillins; Rifampin; Treatment Outcome

A 71-year-old male patient with a superficial transitional cell carcinoma of the urinary bladder developed high fever and jaundice, accompanied by progressively increasing serum aminotransferase activities, 2 weeks after the fourth local instillation with an attenuated live strain of Mycobacterium bovis [bacillus Calmette-Guérin (BCG)]. A liver biopsy showed non-caseating granulomatous hepatitis. Cultures for mycobacteria were negative. Mycobacterial DNA was not detected in liver tissue using the polymerase chain reaction. Empirical treatment with rifampicin and isoniazid was started, resulting in partial recovery. After 6 months of therapy, however, serum aminotransferase activities were still twice the upper limit of normal. A second liver biopsy still demonstrated several granulomas. Only after addition of prednisolone, liver tests completely normalized. Also histologically the lesions improved dramatically. This suggests that the BCG hepatitis was at least partially caused by a hypersensitivity reaction. Our patient is the first reported case of BCG hepatitis with histological follow-up under therapy.

Topics: Adjuvants, Immunologic; Administration, Intravesical; Aged; Antitubercular Agents; BCG Vaccine; Biopsy; Carcinoma, Transitional Cell; Drug Hypersensitivity; Drug Therapy, Combination; Hepatitis; Humans; Immunosuppressive Agents; Isoniazid; Liver; Male; Prednisolone; Rifampin; Transaminases; Treatment Outcome; Urinary Bladder Neoplasms

Many of the adverse events induced by rifampin have been considered allergic in origin. The flu-like syndrome and other hypersensitivity reactions seem to be caused by immune complexes, although their pathogenetic mechanisms are not fully elucidated. Many cases have been reported of the flu-like syndrome, thrombocytopenia, hemolytic anemia, and renal failure caused by rifampin. In almost all of the patients in whom they were sought, nonreaginic antirifampin antibodies were detected. On the other hand, anaphylactic reactions seem to be IgE-mediated. We have analyzed the 18 reported cases of anaphylactic reactions severe enough to cause marked hypotension. The interval between the onset of treatment and the anaphylactic reaction was highly variable. Most patients presented with prodromes, mainly rash, before the development of anaphylactic symptoms, and, in most cases, the reaction occurred after reexposure to rifampin. Clinical findings include a variety of symptoms, such as fever, exanthem, dyspnea, abdominal pain, and vomiting. Seven of the 9 patients in whom HIV status was known were seropositive, including the only 2 patients who died. We believe that, in case of a non-life-threatening adverse reaction caused by immune complexes, rifampin could be readministered, if necessary, at a more frequent and reduced dose, perhaps with the addition of corticosteroids. In case of anaphylactic reactions the drug should be avoided, although desensitization procedures may be useful. Certain laboratory findings may serve as a clue to predict anaphylactic reactions in patients who have experienced minor adverse events to rifampin. However, the diagnostic value of such findings is not well established and, therefore, patients with previous adverse reactions should be carefully monitored if reexposure to rifampin is essential.

Topics: Anaphylaxis; Antibiotics, Antitubercular; Drug Hypersensitivity; Humans; Incidence; Rifampin

Topics: Antitubercular Agents; Drug Hypersensitivity; Humans; Isoniazid; Pyrazinamide; Rifampin; Streptomycin

Topics: Acne Vulgaris; Adult; Amikacin; Antitubercular Agents; Drug Hypersensitivity; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Male; Middle Aged; Pellagra; Pigmentation Disorders; Prothionamide; Pyrazinamide; Rifampin; Skin Diseases; Streptomycin; Thioacetazone

Topics: Animals; Anti-Glomerular Basement Membrane Disease; Anti-Inflammatory Agents; Antibodies; Captopril; Drug Hypersensitivity; Environmental Exposure; Glomerulonephritis; Gold; Heroin; Humans; Hydrocarbons; Hypersensitivity, Delayed; Hypersensitivity, Immediate; Immune Complex Diseases; Kidney Diseases; Kidney Glomerulus; Lupus Erythematosus, Systemic; Mercury; Nephritis, Interstitial; Penicillamine; Penicillins; Rifampin

(1) AIN is the most frequent pattern of drug-induced immunologically mediated renal injury. A number of drugs may be responsible for AIN, namely methicillin and other penicillin derivatives, rifampicin, phenindione and sulfonamides. Particular clinical and pathological features often suggest an immune pathogenetic mechanism. IgG anti-TBM and IgE antibodies have been found in only a few cases and it is likely that antibody-mediated and cell-mediated injury may operate in the same patient. (2) Only few examples of drug-induced vasculitis and glomerulonephritis are known, and the pathophysiology of this kind of renal damage is poorly understood.

Topics: Acute Kidney Injury; Antigens; Basement Membrane; Drug Hypersensitivity; Glafenine; Glomerulonephritis; Humans; Kidney; Kidney Glomerulus; Kidney Tubules; Methicillin; Nephritis, Interstitial; Penicillin G; Penicillins; Phenindione; Rifampin; Sulfonamides; Vasculitis

A new case of acute renal failure after rifampicin is presented, together with a review of the 36 similar cases published up to date in the literature. Evidence is provided that irregularities in drug intake, either as true intermittent treatment or as discontinuation of continuous therapy, play an important role in the pathogenesis of such reactions. Renal failure appeared after a rather long uneventful interval from the beginning of rifampicin therapy, ranging from 1 month to more than 1 year. Its clinical course was favourable in all but one case; the histological picture was mainly of tubulo-interstitial type. The controversial immunological data reported in the literature are reviewed; an increase of histamine release by rat mast cells has been found in presence of rifampicin plus the serum of our patient: the implications of this finding are discussed, suggesting a possible immunological factor in the pathogenesis of acute renal failure after rifampicin.

Topics: Acute Kidney Injury; Adult; Drug Administration Schedule; Drug Hypersensitivity; Humans; Male; Rifampin

Topics: Acute Kidney Injury; Anaphylaxis; Anemia, Hemolytic; Dose-Response Relationship, Drug; Drug Hypersensitivity; Humans; Hypotension; Purpura, Thrombocytopenic; Rifampin

We prospectively evaluated the effectiveness of desensitization therapy for cases showing side-effects to antituberculous drugs (Isoniazid and Rifampicin) according to the guideline proposed by the Treatment Committee of the Japanese Society for Tuberculosis. Nineteen patients (23-88 years old, male 9, female 10) who had experienced adverse effects after receiving antituberculous drugs and underwent desensitization therapy between August 1998 and March 2000 were studied. Underlying diseases were 14 cases of pulmonary tuberculosis, 2 cases of cervical tuberculous lymphadenitis, 1 case of pulmonary atypical mycobacteriosis, 1 case of pulmonary tuberculosis and tuberculous pleuritis, 1 case of pulmonary tuberculosis and tuberculous lymphadenitis. The regimens of treatment for tuberculosis were INH + RFP + EB in 8 cases, INH + RFP + EB + PZA in 7 cases, INH + RFP + SM in 2 cases, INH + RFP + SM + PZA in 1 case, and INH + RFP in 1 case. Adverse reactions were 8 cases of eruption, 7 cases of drug fever, 3 cases of drug fever and eruption, and 1 case of drug fever and cervical lymphadenopathy. The causative drugs suggested from DLST or the clinical course were RFP in 17 cases and INH in 8 cases. The clinical effect of desensitization therapy for these antituberculous drugs was good in 14 out of the 17 cases (82%) for RFP, and in 6 out of 8 cases (75%) for INH. The effectiveness rate of the present desensitization therapy according to the guideline of the Japanese Society for Tuberculosis was almost equal to that of previous desensitization therapy, and the clinical results were almost same in present and previous studies despite the different methods of administration of the antituberculous drugs.

Topics: Adult; Aged; Aged, 80 and over; Antitubercular Agents; Desensitization, Immunologic; Drug Hypersensitivity; Female; Humans; Isoniazid; Japan; Male; Middle Aged; Practice Guidelines as Topic; Prospective Studies; Rifampin; Tuberculosis; Tuberculosis Societies

Among HIV-positive patients who received treatment for active tuberculosis, thiacetazone has been associated with cutaneous hypersensitivity and recurrent tuberculosis. No controlled trials have investigated the safety and efficacy of thiacetazone-containing regimens compared with alternative regimens among patients with HIV. In a randomised clinical trial of 191 HIV-positive patients with active pulmonary tuberculosis, we examined the safety and short-term efficacy of isoniazid, rifampicin, and pyrazinamide for two months followed by isoniazid and rifampicin for seven months (RHZ) compared with streptomycin, thiacetazone, and isoniazid for two months followed by thiacetazone and isoniazid for ten months (STH). Between May, 1990, and September, 1991, 191 HIV-positive adult Ugandan patients with acid-fast bacilli sputum smear-positive pulmonary tuberculosis (93% confirmed by culture) received either STH or RHZ. Subjects had a standard evaluation that included Mantoux skin test, complete blood count with differential white blood cell count, and chest radiography. After starting therapy, subjects were followed-up over one year for three outcomes: complications of anti-tuberculosis therapy, early sterilisation of cultures, and survival. Of 191 eligible subjects, 90 received STH and 101 received RHZ. The overall one-year survival was similar for STH and RHZ (65% vs 72%), but when controlled for baseline differences in Mantoux reaction size and absolute lymphocyte count, the relative risk of death for STH compared with RHZ was 1.57 (95% CI 1.0-2.48). Overall, 12 adverse drug reactions occurred in the STH arm (18.2 reactions per 100 person years [PYO]) compared with one in the RHZ arm (1.6 reactions per 100 PYO) for a relative risk of 11.7 (95% CI 1.52-90.0). 10 cutaneous reactions occurred in the STH arm (15.2 events per 100 PYO) compared with one event in the RHZ arm (1.6 events per 100 PYO) for a relative risk of 9.7 (95% CI: 1.24, 75.8). A greater proportion of RHZ patients compared with STH patients had sterilised their sputum within two months (74% vs 37%, p < 0.001). In developing countries, rifampicin-containing regimens should be given, when possible, to HIV-positive patients to reduce drug toxicity and to prolong survival.

Topics: Adolescent; Adult; AIDS-Related Opportunistic Infections; Drug Eruptions; Drug Hypersensitivity; Drug Therapy, Combination; Female; Humans; Isoniazid; Male; Middle Aged; Pyrazinamide; Rifampin; Streptomycin; Survival Rate; Thioacetazone; Tuberculosis, Pulmonary; Uganda

Topics: Adolescent; Adult; Aged; Arkansas; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Hypersensitivity; Ethambutol; Female; Humans; Isoniazid; Male; Middle Aged; Rifampin; Streptomycin; Time Factors; Tuberculosis, Pulmonary

In a controlled trial in Hong Bong, 575 Chinese patients with pulmonary tuberculosis whose treatment with first-line regimens had failed were allocated at random to the following retreatment regimens of chemotherapy. (1) Rifampicin plus ethambutol daily (ER7). (2) Rifampicin plus ethambutol twice a week (ER2). (3) Rifampicin plus ethambutol once a week (ER1). (4) Rifampicin plus ethambutol daily for 2 months and then once a week (ER7ER1). (5) Ethionamide plus pyrazinamide plus cycloserine daily for 6 months and then ethionamide plus pyrazinamide daily (EtZC), as a control regimen. Answers to a questionnaire on allergic disease, the results of prick tests with standard allergens, ABO blood grouping, size of tuberculin response during chemotherapy, and a rifampicin patch test showed no associations with the occurrence of adverse reactions to daily or intermittent rifampicin. Mantoux testing during chemotherapy provided no evidence of an immunosuppressive effect of rifampicin. Mean platelet counts at 12 months were significantly lower than those at 3 months on the two once-weekly regimens (ER1, ER7ER1) and on the control regimen (EtZC), although still within normal limits. At 3 months, but not at 12 months, mean platelet counts on the two once-weekly regimens were significantly lower 6 hr after a dose of the regimen than they were before the dose.

Topics: ABO Blood-Group System; Blood Cell Count; China; Clinical Trials as Topic; Cycloserine; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Ethionamide; Hematocrit; Hemoglobins; Hong Kong; Humans; Pyrazinamide; 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: Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Gastrointestinal Diseases; Humans; Isoniazid; Mycobacterium tuberculosis; Phenylthiourea; Pyridoxine; Recurrence; Rifampin; Streptomycin; Thrombocytopenia; Time Factors; Tuberculosis, Pulmonary

Topics: Clinical Trials as Topic; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Fever; Gastrointestinal Diseases; Humans; Jaundice; Purpura, Thrombocytopenic; Respiratory Insufficiency; Rifampin; Skin Manifestations; Time Factors; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Clinical Trials as Topic; Drug Administration Schedule; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Female; Hong Kong; Humans; Male; Middle Aged; Pyrazinamide; Rifampin; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Aminosalicylic Acids; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Hypersensitivity; Drug Resistance, Microbial; Ethambutol; Female; Humans; Isoniazid; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium tuberculosis; Radiography; Rifampin; Skin Diseases; Sputum; Streptomycin; Time Factors; Tuberculosis, Pulmonary; United Kingdom

Topics: Aminosalicylic Acids; Anti-Bacterial Agents; Clinical Trials as Topic; Drug Hypersensitivity; Drug Resistance, Microbial; England; Ethambutol; Humans; Hypocalcemia; Hypokalemia; Isoniazid; Kidney Diseases; Labyrinth Diseases; Magnesium; Rifampin; Streptomycin; Vision Disorders; Water-Electrolyte Balance

Topics: Adult; Aged; Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Hypersensitivity; Drug Resistance, Microbial; Drug Synergism; Ethambutol; Female; Finland; Hearing Disorders; Humans; Kidney Diseases; Male; Middle Aged; Pneumothorax; Rifampin; Tuberculosis, Pulmonary; Vision Disorders

Topics: Adult; Aged; Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Hypersensitivity; Eosinophilia; Ethambutol; Female; Gastrointestinal Diseases; Humans; Kidney Diseases; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary; Uric Acid; Vision Disorders

This study aimed to evaluate hypersensitivity reactions to anti-tuberculosis (TB) drugs.. We retrospectively compared the clinical manifestations and treatment outcomes of single and multiple drug hypersensitivity reactions (DHRs).. Twenty-eight patients were diagnosed with anti-TB DHRs using oral drug provocation tests. Of these 28 patients, 17 patients (60.7%) had DHRs to a single drug and 11 (39.3%) had multiple DHRs. The median age of patients was 57.5 years (interquartile range [IQR], 39.2-73.2). Of the total patients, 18 patients (64.3%) were men. The median number of anti-TB drugs causing multiple DHRs was 2.0 (IQR 2.0-3.0). Rifampin was the most common drug that caused DHRs in both the single and multiple DHR groups (n = 8 [47.1%] and n = 9 [52.9%], respectively). The treatment success rate was lower in the multiple DHR group than in the single DHR group; however, the difference was not statistically significant (81.8% vs. 94.1%; P = 0.543).. Multiple anti-TB DHRs were common in all patients who experienced DHRs, and rifampin was the most common causative drug. The treatment outcomes appeared to be poorer in patients with multiple DHRs than in those with single DHRs.

Topics: Adult; Aged; Antitubercular Agents; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Male; Middle Aged; Republic of Korea; Retrospective Studies; Rifampin; Treatment Outcome

Leprosy is a stigmatizing, chronic infection which degenerates the nervous system and often leads to incapacitation. Multi-drug therapy which consists of dapsone, rifampicin and clofazimine has been effective to combat this disease. In Indonesia, especially in Papua Island, leprosy is still a problem. Furthermore, there had been higher reports of Dapsone Hypersensitivity Syndrome (DHS) which also challenges leprosy elimination in certain aspects. Globally, DHS has a prevalence rate of 1.4% and a fatality rate up to 13%. The aim of this study is to validate HLA-B*13:01, a previously discovered biomarker for DHS in the Chinese population, as a biomarker for DHS in the Papua population.This is a case-control study of 34 leprosy patients who presented themselves with DHS (case subjects) and 52 leprosy patients without DHS (control subjects). Patients were recruited from 2 provinces: Papua and West Papua. DNA was extracted from 3 ml blood specimens. HLA-B alleles were typed using the gold-standard sequence based typing method. Results were then analysed using logistic regression and risk assessment was carried out. The results of HLA-typing showed that HLA-B*13:01 was the most significant allele associated with DHS, with odds ratio = 233.64 and P-value = 7.11×10-9, confirming the strong association of HLA-B*13:01 to DHS in the Papua population. The sensitivity of this biomarker is 91.2% and specificity is 96.2%, with an area under the curve of 0.95. HLA-B*13:01 is validated as a biomarker for DHS in leprosy patients in Papua, Indonesia, and can potentially be a good predictor of DHS to help prevent this condition in the future.

Topics: Adolescent; Adult; Alleles; Biomarkers; Case-Control Studies; Clofazimine; Dapsone; Drug Hypersensitivity; Drug Therapy, Combination; Female; HLA-B13 Antigen; Humans; Indonesia; Leprostatic Agents; Leprosy; Logistic Models; Male; Rifampin; Risk Assessment; Syndrome; Young Adult

Drug-related hypersensitivity myocarditis is a rare acute hypersensitivity reaction to therapeutic agents. Reports of antitubercular drugs causing hypersensitivity myocarditis are not described in literature.. Retrospective chart review of children admitted between January 1, 2016, and March 31, 2019, was conducted to identify children receiving antitubercular drugs who were diagnosed with hypersensitivity myocarditis.. Three children (2 girls), who had hypersensitivity myocarditis due to antitubercular therapy, were identified. Cases 1 and 2 developed hypersensitivity myocarditis due to rifampicin, and isoniazid-rifampicin combination, respectively, on reintroduction of drugs, while case 3 developed hypersensitivity to streptomycin on first exposure. All children developed symptoms within minutes to hours of starting the offending drugs. Severe myocardial dysfunction leading to shock and pulmonary edema was seen in cases 1 and 3, while case 2 presented with wide QRS complex ventricular rhythm with bradycardia and hypotensive shock. Cases 1 and 2 were treated with steroids. Cases 1 and 3 received intravenous immunoglobulin therapy. First 2 children survived while third died of refractory shock. Total serum IgE levels were elevated in all children (range: 161-3053 kU/L).. Hypersensitivity myocarditis is a rare but life-threatening adverse effect of antitubercular drugs. Prompt diagnosis of hypersensitivity myocarditis and timely steroid therapy can be lifesaving.

Topics: Adolescent; Antitubercular Agents; Child; Drug Hypersensitivity; Female; Humans; Isoniazid; Male; Myocarditis; Retrospective Studies; Rifampin

Delayed drug hypersensitivity to first-line anti-tuberculosis medication is a major challenge in tuberculosis treatment.. This study was performed to investigate the efficacy/tolerability of desensitization therapy in treatment of first-line anti-tuberculosis medication hypersensitivity and the usefulness of immunologic evaluation therein.. This study was conducted as a prospective, observational cohort study. Subjects who experienced hypersensitivity reactions, including maculopapular exanthema (MPE) and drug reaction with eosinophilia and systemic symptoms (DRESS), to first-line anti-tuberculosis medications (isoniazid [INH], ethambutol [EMB], rifampin [RFP], and pyrazinamide [PZA]) were enrolled. Patch, intradermal, lymphocyte transformation, and oral provocation tests were performed to determine culprit drugs, which were desensitized with rapid and graded challenge protocols. Breakthrough reactions (BTRs) during or after desensitization were assessed.. In total, 31 desensitization treatments (INH, 8; EMB, 8; RFP, 11; PZA, 4) to 12 patients (8 with MPE and 4 with DRESS) were performed. The overall success rate of desensitization was 80.7%. All the study subjects except one completed the full course of anti-tuberculosis treatment. The overall BTR free rate was 64.5%. Sixteen (80%) treatments for MPE and four (36.4%) for DRESS were BTR free (P = 0.023). Drugs that were positive on any two of three immunologic studies showed significantly high BTR rates (P = 0.014), although this was not correlated with desensitization failure rate.. Rapid desensitization therapy to multiple anti-tuberculosis medications for delayed drug hypersensitivity was safe and successful. Combination of multiple immunologic evaluations may predict BTR although it needs validation in larger studies.

Topics: Adult; Aged; Aged, 80 and over; Antitubercular Agents; Desensitization, Immunologic; Drug Hypersensitivity; Ethambutol; Female; Humans; Incidence; Isoniazid; Male; Middle Aged; Prospective Studies; Pyrazinamide; Rifampin; Tuberculosis

Rifampicin (RFP) and pyrazinamide (PZA) are the primary anti-tubercular drugs with a considerably safe profile. However, none of the drugs are without adverse reactions. They both can lead to a variety of adverse effects including life-threatening anaphylaxis. We report an interesting and possibly the first case of concurrent hypersensitivity to two primary anti-tubercular treatment (ATT) drugs. Hypersensitivity to RFP and PZA was confirmed in this patient by drug provocation and intradermal skin testing. He improved on alternative ATT regime withdrawing RFP and PZA.

Topics: Anaphylaxis; Antitubercular Agents; Child; Drug Hypersensitivity; Humans; Male; Pyrazinamide; Rifampin; Tuberculosis, Meningeal

Multiple drug hypersensitivity (MDH) is an allergy to two or more chemically unrelated drugs. We present a case of MDH caused by antituberculosis agents during the treatment of tuberculous meningitis (TBM). A 64-year-old man without a history of drug allergy developed fever and severe headache. Examination of cerebrospinal fluid showed lymphocytosis, a low glucose level, and a high ADA activity, suggestive of TBM. The patient was treated with isoniazid, rifampicin, pyrazinamide, and ethambutol, and his symptoms resolved quickly. However, 20 days after the initiation of therapy, he developed remittent fever without mucocutaneous lesions. A drug-induced lymphocyte stimulation test was positive for isoniazid, rifampicin, and pyrazinamide, which was consistent with a diagnosis of MDH. All the antituberculosis drugs were replaced with levofloxacin and ethionamide, both of which have excellent cerebrospinal fluid penetration, and the fever subsided. The patient made a full recovery from TBM. Because standard antituberculosis regimens include three or four antituberculosis drugs, it is difficult to determine the culprit drug when hypersensitivity occurs. Moreover, there can be multiple causative drugs as illustrated by the present case. During a time-consuming desensitization therapy, TBM could flare up, leading to permanent neurological damage. Thus, treatment with suitable alternative drugs should be started immediately.

Topics: Antitubercular Agents; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Ethionamide; Humans; Immunologic Tests; Isoniazid; Levofloxacin; Lymphocyte Activation; Male; Middle Aged; Pyrazinamide; Rifampin; Treatment Outcome; Tuberculosis, Meningeal

Topics: Child; Clinical Protocols; Contraindications; Desensitization, Immunologic; Diphenhydramine; Drug Dosage Calculations; Drug Hypersensitivity; Exanthema; Glucosephosphate Dehydrogenase Deficiency; Humans; Immune Tolerance; Isoniazid; Latent Tuberculosis; Male; Rifabutin; Rifampin

Topics: Administration, Oral; Anti-Bacterial Agents; Child, Preschool; Desensitization, Immunologic; Drug Hypersensitivity; Humans; Latent Tuberculosis; Rifampin; Treatment Outcome

Topics: Clindamycin; Discitis; Drug Hypersensitivity; Drug Substitution; Female; Humans; Levofloxacin; Low Back Pain; Lumbar Vertebrae; Magnetic Resonance Imaging; Middle Aged; Radionuclide Imaging; Rifampin; Streptococcal Infections; Streptococcus

Sinus lift is a predictable procedure for increasing alveolar bone height in the posterosuperior alveolar regions to allow oral prosthetic rehabilitation. Several complications have been documented in the literature and vary from sinus membrane perforation to maxillary rhinosinusitis. The authors present a case of Gemella morbillorum acute sinusitis after sinus lift surgery. The purpose of this report is to describe the surgical and pharmacological management of a patient allergic to penicillin.

Topics: Anti-Bacterial Agents; Bone Transplantation; Drug Hypersensitivity; Endoscopy; Female; Follow-Up Studies; Gemella; Gram-Positive Bacterial Infections; Humans; Levofloxacin; Maxillary Sinusitis; Middle Aged; Penicillins; Reoperation; Rifampin; Sinus Floor Augmentation; Surgical Wound Infection; Vancomycin

Six-month regimen consisting of two-month initial intensive phase of isoniazid (INH), rifampicin (RFP), pyrazinamide (PZA) and ethambutol, (or streptomycin) and four-month maintenance phase of INH and RFP has been established as the global standard. Alternatively, 9-month regimen without PZA is acceptable for patients like elderly persons. Standard regimen is well tolerated in most patients. However some patients have adverse reactions. The frequent and serious reaction is hepatic toxicity caused by INH and PZA. Close monitoring of serum aminotransferase at every two weeks of initial treatment phase is recommended. Hypersensitivity to INH and RFP is common reaction seen in 4-5 percent of the general population. About 60-80% patients who had hypersensitivity can continue the standard regimen by desensitization therapy.

Topics: Aged, 80 and over; Antitubercular Agents; Child; Drug Administration Schedule; Drug Hypersensitivity; Ethambutol; Female; Humans; Isoniazid; Liver; Pregnancy; Pyrazinamide; Rifampin; Tuberculosis

Leprosy is rare in Australia, particularly in the southern states. We report two cases of leprosy in southern Australia that presented to the dermatology outpatients' department within a 4-month period. The presentation of the first case was complex, making the correct diagnosis difficult. Both cases involved immigrants from South-East Asia, were classified as multi-bacillary leprosy as defined by the World Health Organization, and were commenced on the recommended multiple drug therapy. The ensuing clinical course was complicated, with both cases developing Type 1 leprosy reactions. The first case also developed the rare but serious dapsone-induced delayed hypersensitivity reaction.

Topics: Adult; Aged, 80 and over; Arm; Back; Clofazimine; Dapsone; Diagnosis, Differential; Drug Hypersensitivity; Drug Therapy, Combination; Face; Female; Forearm; Glucocorticoids; Humans; Leprostatic Agents; Leprosy, Borderline; Male; Mycobacterium leprae; Rifampin; Treatment Outcome

Topics: Acute Kidney Injury; Adult; Anaphylaxis; Anemia, Hemolytic; Antibiotics, Antitubercular; Disseminated Intravascular Coagulation; Drug Hypersensitivity; Humans; Hypersensitivity, Immediate; Liver; Male; Renal Dialysis; Rifampin; Treatment Outcome; Tuberculosis, Pulmonary

Topics: Acetamides; Ampicillin; Anti-Bacterial Agents; Brain Abscess; Drug Hypersensitivity; Drug Therapy, Combination; Humans; Linezolid; Listeriosis; Male; Middle Aged; Oxazolidinones; Rifampin; Trimethoprim, Sulfamethoxazole Drug Combination

Dapsone syndrome is a rare hypersensitivity reaction to dapsone and is characterized by high fever, papular or exfoliative dermatitis, progressing to liver toxicity and generalized lymphadenopathy, resembling a mononucleosis infection. We report a patient who developed acute renal failure, as well as other complications characteristic of dapsone syndrome, during leprosy treatment. Renal involvement had not been previously described as a dapsone syndrome feature.

Topics: Acute Kidney Injury; Adult; Clofazimine; Dapsone; Drug Hypersensitivity; Drug Therapy, Combination; Female; Humans; Leprostatic Agents; Leprosy; Rifampin; Syndrome

We describe clinical and pathological features of kidney and skin involvement in a patient with hypersensitivity vasculitis associated with dapsone. Although visceral damage occurs rarely, similar skin and kidney histopathologic and immunohistochemical findings indicate that this organ is a target for type IV cell-mediated dapsone reaction. To our knowledge, this is the first reported case of renal hypersensitivity vasculitis associated with dapsone.

Topics: Adult; Anti-Bacterial Agents; Antitubercular Agents; Clofazimine; Cyclophosphamide; Dapsone; Drug Hypersensitivity; Drug Therapy, Combination; Female; Humans; Immunosuppressive Agents; Kidney Diseases; Leprostatic Agents; Leprosy; Methylprednisolone; Rifampin; Tuberculosis, Pulmonary; Vasculitis, Leukocytoclastic, Cutaneous

Topics: Adult; Antitubercular Agents; Diagnosis, Differential; Drug Hypersensitivity; Ethambutol; Exanthema; Fever; Humans; Isoniazid; Liver; Liver Failure; Male; Pyrazinamide; Pyridoxine; Rifampin; Skin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Aged, 80 and over; Antibiotics, Antitubercular; Drug Hypersensitivity; Drug Interactions; Female; HIV Protease Inhibitors; Humans; Rifabutin; Rifampin; Tuberculosis

Topics: Administration, Oral; Antibiotics, Antitubercular; Antitubercular Agents; Child; Desensitization, Immunologic; Drug Hypersensitivity; Ethambutol; Female; Humans; Isoniazid; Rifampin; Time Factors

The side effects of rifampicine due to an immunoallergic mechanism are rare and usually observed during discontinued treatment or administration of high doses.. An immediate hypersensitivity reaction with anaphylactic manifestations and increase in IgE occurred in a 39 year-old man suffering from resistant tuberculosis. The reaction occurred within the first hour following a low dose of rifampicin administered in a desensitisation attempt, the outcome of which was favourable after administration of corticosteroids and antihistamines. A type II hypersensitivity reaction occurred in a 76 year-old male patient in the form of thrombopenia on D76 of a twice weekly treatment, diagnosed because of hemoptysis with normalisation of platelet level on withdrawal of rifampicin. An immune complex hypersensitivity reaction was responsible for hepato-renal failure on D68 of twice weekly treatment and required permanent withdrawal of rifampicin and dialysis, which led to subsequent improvement.. These clinical cases illustrate the variability of the hypersensitivity mechanisms observed with rifampicin, the difficulty in imputability tests and methods for immunological confirmation, the interest of continuous treatment which avoids a certain number of these accidents, and that of desensitisation during immediate hypersensitive reactions which permits the continuation this major anti-tuberculosis drug.

Topics: Acute Kidney Injury; Adult; Aged; Anaphylaxis; Antibiotics, Antitubercular; Antigen-Antibody Complex; Desensitization, Immunologic; Drug Hypersensitivity; Humans; Hypersensitivity, Immediate; Liver Failure; Male; Platelet Count; Rifampin; Thrombocytopenia; Time Factors

Topics: Acute Kidney Injury; Adolescent; Cluster Analysis; Drug Hypersensitivity; Female; Follow-Up Studies; Humans; Pedigree; Rifampin; Risk Assessment; Tuberculosis, Pulmonary

A 69-y-old woman with bioprosthetic endocarditis due to Listeria monocytogenes developed an allergic reaction after beginning ampicillin treatment. She was cured with the combination of trimethoprim-sulfamethoxazole, rifampicin and teicoplanin. No immune deficiency was found in the patient.

Topics: Aged; Anti-Bacterial Agents; Drug Hypersensitivity; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Humans; Listeria monocytogenes; Listeriosis; Penicillins; Prosthesis-Related Infections; Rifampin; Teicoplanin; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Antibiotics, Antitubercular; Desensitization, Immunologic; Drug Hypersensitivity; Female; Hepatitis; Humans; Hypersensitivity, Immediate; Injections, Intravenous; Middle Aged; Nephritis; Rifampin; Tuberculosis, Lymph Node; Urticaria

The usefulness of the lymphocyte transformation test (LTT) for the analysis of adverse reactions to antituberculous drugs was evaluated. - The LTT was performed with isoniazid and rifampicin in 15 tuberculosis and 2 MOTT (Mycobacteria other than tuberculosis)-infection patients who suffered drug reactions, in 23 patients without any adverse reactions, in 7 controls previously exposed to antituberculous drugs, and in 14 controls who had never been exposed. 4/15 of the hepatotoxic reactions only showed a positive LTT with rifampicin, 3/15 only with isoniazid, and in 8/15 the LTT was negative. In an anaphylactoid shock reaction the LTT was extremely exaggerated for both rifampicin and isoniazid. In patients without any side effects only one slightly increased LTT due to isoniazid was observed. Two healthy controls with previous contact to these drugs showed a positive LTT for isoniazid, one of those with both rifampicin and isoniazid. The LTT was negative in all control persons without any former contact to antituberculous medications. In most cases hepatotoxicity seems to be a pure toxic reaction without the participation of cellular immune mechanisms. LTT can be useful for identifying the drug responsible for immunological side effects.

Topics: Adult; Anaphylaxis; Anti-Bacterial Agents; Antitubercular Agents; Bromodeoxyuridine; Cells, Cultured; Chemical and Drug Induced Liver Injury; DNA Replication; Drug Eruptions; Drug Hypersensitivity; Drug Therapy, Combination; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunity, Cellular; Isoniazid; Kidney Diseases; Leukocytes, Mononuclear; Lymphocyte Activation; Male; Middle Aged; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Mycobacterium kansasii; Nervous System Diseases; Rifampin; Tuberculosis

Topics: Administration, Topical; Adult; Anaphylaxis; Antibiotics, Antitubercular; Drug Hypersensitivity; Female; Humans; Male; Ophthalmic Solutions; Rifampin

Rifampicin is a major drug used for the treatment of mycobacterial infections. It is usually well tolerated although cases of immunoallergic events have been reported in discontinuous regimens.. We report the case of a 55-year-old man who developed a severe drug reaction after taking rifampicin daily for two months with no interruption. The clinical course was favorable after drug withdrawal. Challenge with other antituberculous drugs did not induce any adverse reaction.. Despite the few cases reported, antituberculous regimens containing rifampicin can cause severe adverse reactions which subside progressively after drug withdrawal.

Topics: Antibiotics, Antitubercular; Antibodies; Diagnosis, Differential; Drug Eruptions; Drug Hypersensitivity; Drug Therapy, Combination; Eosinophilia; Humans; Long-Term Care; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Hypersensitivity reactions to rifampin are relatively uncommon, but they may result in cessation of therapeutic medications.. We report our experience with oral desensitization protocol to rifampin in a group of 35 HIV-positive patients with mycobacterial disease who had some hypersensitivity reaction to this drug.. Adverse reactions with this protocol were few and easily treated.. Oral desensitization to rifampin is safe and effective, allowing some of these patients (60%) to reintroduce the drug and to reduce the time of treatment.

Topics: Acquired Immunodeficiency Syndrome; Adult; Antibiotics, Antitubercular; Desensitization, Immunologic; Drug Hypersensitivity; Female; Humans; Male; Rifampin; Tuberculosis

Topics: Adult; Anaphylaxis; Antibiotics, Antitubercular; Antitubercular Agents; Cerebral Infarction; Drug Hypersensitivity; Drug Therapy, Combination; HIV Infections; Humans; Isoniazid; Male; Pyrazinamide; Rifampin; Tuberculosis, Pulmonary

Topics: AIDS-Related Opportunistic Infections; Desensitization, Immunologic; Drug Hypersensitivity; Humans; Rifampin; Tuberculosis

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

Evaluate the effect of HIV infection in the appearance of toxicity in patients treated with rifampin, analysing the involved elements in its genesis.. We realized a comparative study of the epidemiologic and clinical characteristics, and the incidence of adverse reactions to rifampin (between 1986-1993), comparing the seropositive patients treated with rifampin, during more than 3 months, with one control group, of equal number of patients, without evidence of HIV infection, taken at random, with epidemiologic characteristics (age and sex) similar to the first group and also treated with rifampin during a similar period. In the group with HIV infection, we analysed the related epidemiologic, clinical and analytic characteristics, in a way statistically significative, with the appearance of toxicity to rifampin.. The risk of toxicity to rifampin was associated significantly to HIV infection (p < 0.01), without finding any other distinguishing characteristics among the analysed groups. Indicative parameters of advanced HIV infection: advanced clinical stage, minor level of lymphocytes CD4+, total leukocytes, total lymphocytes and quotient CD4+/CD8+, also high levels of beta 2-microglobulinemia and [correction of 2-microglobulina e] IgA, and a negative protein purified derivative test (PPD) were found statistically related with the appearance to toxicity to rifampin. Patients with number of lymphocytes CD4+ between 20-50/mm3, showed a major predisposition of suffering toxicity to rifampin.. HIV infection involved a notably increase of toxicity risk to rifampin. Clinical or analytic parameters associated with advanced illness conditioned an increase of this risk, essentially among patients with number of CD4+ between 20-50/mm.

Topics: Adult; AIDS-Related Opportunistic Infections; Antibiotics, Antitubercular; Drug Hypersensitivity; Female; HIV Infections; HIV Seronegativity; HIV-1; Humans; Immunity, Cellular; Incidence; Male; Rifampin; Risk Factors; Spain; Tuberculosis, Pulmonary

Topics: Administration, Oral; Adult; Antibiotics, Antitubercular; Desensitization, Immunologic; Drug Hypersensitivity; Humans; Male; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Drug Hypersensitivity; Humans; Leprostatic Agents; Leprosy; Male; Middle Aged; Rifampin

Topics: Adult; Antitubercular Agents; Drug Hypersensitivity; Female; Humans; Isoniazid; Liver Failure, Acute; Liver Function Tests; Male; Middle Aged; Pyrazinamide; Rifampin

Topics: Adult; Antigen-Antibody Complex; Drug Hypersensitivity; Female; Fever; Headache; Humans; Leprosy; Male; Nausea; Rifampin; Syndrome; Vomiting

Topics: Adult; Antibiotics, Antitubercular; Diagnosis, Differential; Drug Hypersensitivity; Female; Humans; Lung; Radiography; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Antibiotics, Antitubercular; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Drug Administration Schedule; Drug Hypersensitivity; Ethambutol; Humans; Isoniazid; Male; Middle Aged; Purpura; Pyrazinamide; Rifampin; Streptomycin; Thrombocytopenia; Tuberculosis, Pulmonary

Topics: Antibodies, Antinuclear; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Humans; Male; Middle Aged; Rifampin

Topics: Adult; Drug Hypersensitivity; Female; Humans; Immunoglobulin E; Intradermal Tests; Radioallergosorbent Test; Rifampin

This study was conducted at the Department of Paediatrics and Child Health, University Teaching Hospital (UTH), in Lusaka, Zambia.. To monitor the seroprevalence of HIV type-1 in children with tuberculosis and to evaluate the response to anti-tuberculosis therapy using a thioacetazone-free treatment regimen.. A prospective cross-sectional study of all consecutive newly diagnosed cases of TB in children from 1 month-15 years of age seen at the University Teaching Hospital (UTH) in Lusaka, Zambia between 1 October 1991 and 31 May 1992.. 120 children with a clinical diagnosis of tuberculosis and 167 controls were enrolled in the study. The overall HIV type-1 seroprevalence rate in children with tuberculosis was 55.8% (67/120) compared to 9.6% (16/167) amongst the control group (P < 0.0001: odds ratio = 11.50; 95% CI = 5.99-22.7). Common clinical presentations among children with TB were bronchopneumonia (45/162), miliary TB (30/162) and tuberculous lymphadenopathy (21/33). There were no significant differences in clinical presentation of TB between the HIV-negative and HIV-positive groups. The follow-up of those patients with tuberculosis was poor, with only 65 patients (55%) returning to the clinic for scheduled appointments after discharge. All the 16 patients who died did so within 60 days of discharge from hospital; all of them were seropositive for HIV. There were no deaths among the HIV-negative group. Despite the exclusion of thioacetazone from the treatment regimen, cutaneous reactions occurring within 8 weeks of commencing treatment were observed in 7 of the 65 (11%) patients, 2 of whom developed fatal Stevens-Johnson syndrome. All 7 patients were seropositive for HIV-1.. The seroprevalence rate of HIV type-1 among children with tuberculosis in Lusaka continues to rise; careful monitoring of anti-TB therapy (even in regimens excluding thioacetazone) for potentially lethal side effects should be carried out.

Topics: Adolescent; Child; Child, Preschool; Drug Hypersensitivity; Drug Therapy, Combination; Female; HIV Infections; HIV Seroprevalence; HIV-1; Humans; Infant; Isoniazid; Male; Prospective Studies; Pyrazinamide; Rifampin; Streptomycin; Treatment Outcome; Tuberculosis, Pulmonary; Zambia

The presence of rifampicin (RFP) specific IgG in the sera of rabbits immunized with RFP or with two RFP-protein conjugates (RFP-bovine serum albumin, RFP-BSA and RFP-rabbit serum albumin RFP-RSA) was measured by ELISA. The way of conjugation and the molecular conjugation rate were different between RFP-BSA and RFP-RSA. The titre of RFP specific IgG was 1:10-1:100 in RFP immunized rabbits, 1:100-1:1,000 in RFP-RSA immunized rabbits, and over 1:1000 in RFP-BSA immunized rabbits. The binding properties of the sera to RFP were demonstrated by inhibition assay. These are the models of RFP sensitization first established by immunization animals with RFP itself or RFP-protein conjugates.

Topics: Animals; Disease Models, Animal; Drug Hypersensitivity; Enzyme-Linked Immunosorbent Assay; Immunoglobulin G; Male; Rabbits; Rifampin; Serum Albumin, Bovine

A case of acute hepato-renal failure which developed after the oral intake of rifampicin is reported. Allergic reaction on the drug was accompanied by chill, weakness, paraesthesia, skin itch and facial swelling. The case described in the article appears to be all the more interesting due to the fact that severe lethal complication has developed in patient who had a history of allergic reactions on rifampicin.

Topics: Acute Disease; Aged; Drug Hypersensitivity; Drug Therapy, Combination; Fatal Outcome; Female; Hepatorenal Syndrome; Humans; Rifampin; Tuberculosis, Pulmonary

A 46-year-old male tuberculosis patient developed acute renal failure and liver dysfunction following the oral administration of rifampicin (RFP). The mechanism of the reaction was examined by means of enzyme-linked immunosorbent assay (ELISA). 3-formylrifamycin-SV (Formylrifamycin), which is one of RFP metabolites, was conjugated to human serum albumin. ELISA was performed with this conjugate (Formylrifamycin-HSA) as an antigen. We also evaluated 100 tuberculosis patients receiving oral RFP and 45 healthy volunteers in order to determine the incidence of sensitization by RFP. IgG and IgM antibodies specific to Formylrifamycin-HSA were detected in serum from the patient with RFP-induced renal failure. Among the IgG subclasses, IgG1 antibody was detected. IgG and IgG1 antibodies specific to Formylrifamycin-HSA were detected in serum from only one of the 100 tuberculosis patients. Our results indicate that sensitization to RFP can occur on oral administration, and that acute renal failure was caused by IgG, IgM, and IgG1 antibodies specific to Formylrifamycin as a hapten.

Topics: Adult; Aged; Aged, 80 and over; Antibodies; Drug Hypersensitivity; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunization; Immunoglobulin G; Immunoglobulin M; Male; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Drug Hypersensitivity; Humans; Male; Middle Aged; Rifampin; Time Factors

Many reports have shown that rifampicin could induce a variety of adverse effects. However, anaphylactic shock occurring after readministration of rifampicin, to our knowledge, has not been reported thoughtfully. Herein we present a case with anaphylactic shock after readministration of rifampicin. The possible mechanism may be the interaction between IgE antibody and mast cell or basophils. Compared with continuous regimen, intermittent rifampicin regimen has longer interval to accumulate more rifampicin-induced antibodies, and more immunogenic side effects are the sequelae when re-encountered with rifampicin.

Topics: Aged; Anaphylaxis; Drug Hypersensitivity; Humans; Male; Rifampin

Side-effects of antitubercular drugs were evaluated in 662 patients with tuberculosis. Simultaneously 406 of them suffered of chronic alcoholism, 94 suffered of heavy drinking and 162 were not alcohol abusers. The frequency of side-effects in patients with tuberculosis was 31.5% and 56.4% in those with concomitant alcoholism. The latter showed more frequently negative responses to streptomycin. The latter showed more frequently negative responses to streptomycin, ethionamide, rifampycin and kanamycin. They developed toxic reactions that were three times more frequent than in those without alcohol abuse and were accompanied by exacerbation of diseases of the liver, stomach, heart, CNS, peripheral nervous system.

Topics: Alcohol Drinking; Drug Hypersensitivity; Ethionamide; Humans; Isoniazid; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Drug Hypersensitivity; HIV Seropositivity; Humans; Male; Rifampin; Tuberculosis, Pulmonary

A 45-year-old black woman, sputum positive for acid-fast bacilli, developed hypersensitivity to both isoniazid and rifampin. She was admitted to the hospital and desensitized to both medications using modified penicillin protocols. Skin testing was negative to both drugs. Desensitization to isoniazid was complicated by a drug fever that was controlled by prednisone. The patient was able to maintain once-a-day dosing without incident even with steroid taper. To our knowledge, this is the first reported case of dual isoniazid and rifampin hypersensitivity with rapid oral desensitization.

Topics: Desensitization, Immunologic; Drug Hypersensitivity; Female; Humans; Isoniazid; Middle Aged; Rifampin; Skin Tests

To clarify side effects in children, which resulted from the treatment of intrathoracic tuberculosis with rifampicin, 72 patients were examined. The findings were compared with those on 58 identical patients who received a routine combination of chemotherapeutic drugs. Hence, on the basis of this observation it was found that there were no differences in the incidence of adverse reactions in the compared groups, though their nature was varying. The children on rifampicin were observed to develop mild liver dysfunction 2.5 times more frequently. Besides, toxic-allergic reactions were recorded in the majority of the patients. The combination of isoniazid and rifampicin was proved to enhance their toxic and allergic effects. Liver dysfunction in the presence of different adverse reactions presented with a higher activity in the blood serum of indicator liver enzymes and its impaired protein-forming function.

Topics: Adolescent; Antitubercular Agents; Child; Child, Preschool; Drug Hypersensitivity; Drug Therapy, Combination; Female; Humans; Isoniazid; Male; Rifampin; Tuberculosis, Pulmonary

'Flu' syndrome as a complication of intermittent weekly administration of rifampicin is well documented. The rare occurrence of 'flu' syndrome on once monthly rifampicin is reported in this paper.

Topics: Antigen-Antibody Complex; Drug Administration Schedule; Drug Hypersensitivity; Humans; Leprosy; Male; Middle Aged; Rifampin; Syndrome

Topics: Acetaminophen; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Drug Hypersensitivity; Humans; Infant; Isoniazid; Rifampin

Topics: Adult; Drug Hypersensitivity; Female; Humans; Isoniazid; Rifampin; Shock, Septic; Tuberculosis, Pulmonary

The aim of this prospective study was to evaluate the incidence of allergic reactions to drugs compared to other kinds of medical emergencies admitted to the main Hospital in Milan during a 6 months period. At the same time we drew a list of drugs most frequently involved in allergic reactions, and a list of the most frequent symptoms. Using special forms, the medical staff collected patients' data: age, history of atopy, identification of the drug causing the reaction, and any previous reactions. Among 11,407 cases of medical emergencies, we found 163 (1.43%) patients showing drug reactions: the mean age was 27.3; 58.90% were female; atopy was present in 16.56%. The drugs most frequently involved were: pyrazon group (22%); ASA (20.86%); penicillin and derivatives (9.20%); sulfa drugs (6.14%); group B vitamins (4.30%); tetanus toxoid (4.30%); hyposensitizing extracts (3.68%); propionic acid derivatives (2.46%); paracetamol (1.84%); indomethacin (1.23%); rifampicin (1.23%); erythromycin (1.23%); glafenine (1.23%); others (17.80%). Urticaria and/or angioedema were the most frequent symptoms (86.51%), then anaphylactic shock (9.81%) and asthma (3.68%) with regard to anaphylactic shock only 6.20% of the patients had had a previous reaction to the same drug. From these data we can see that the incidence of drug reactions is very low compared to other medical emergencies; penicillin evidenced fewer reactions than expected, while the pyrazon group and ASA confirmed the data from literature.

Topics: Acetaminophen; Adult; Anaphylaxis; Angioedema; Aspirin; Asthma; Drug Hypersensitivity; Emergencies; Erythromycin; Female; Glafenine; Humans; Indomethacin; Italy; Male; Penicillins; Propionates; Prospective Studies; Pyridazines; Rifampin; Urticaria; Vitamin B Complex

A leprosy patient who developed acute renal failure on multidrug therapy is reported. The patient had initially received a once-weekly dose of rifampin and after he had stopped taking the drug for a time, was given rifampin on a once-monthly dose schedule. He recovered completely from his acute renal failure. Kidney biopsy showed interstitial nephritis with mononuclear and eosinophilic cellular infiltrates.

Topics: Acute Kidney Injury; Adult; Dapsone; Drug Hypersensitivity; Drug Therapy, Combination; Humans; Leprosy; Male; Nephritis, Interstitial; Rifampin

Topics: Acute Kidney Injury; Adult; Anaphylaxis; Antitubercular Agents; Drug Hypersensitivity; Female; Humans; Male; Middle Aged; Rifampin

Antibiotics are the principal cause of drug-associated nephropathy. They are responsible for acute interstitial nephropathy (AIN) or acute tubulo-interstitial nephropathy (ATIN) due to two different pathophysiologic mechanisms: a drug-induced immunologic process and direct action due to drug accumulation. 1) Ain of immunologic origin. These are rare and are induced either by beta-lactamines or by rifampicin. Among the beta-lactamines, methicillin is the most often responsible, while penicillin and ampicillin are less often, and only rarely are carbenicillin, oxacillin, nafcillin, cephalothin and cephalexin. Macroscopic hematuria occurring 10 to 15 days after initiation of treatment usually reveals the renal involvement. It is associated with or preceded by fever, skin eruption and blood eosinophilia. Renal insufficiency (RI) is not severe and rarely requires hemodialysis (HD). The course is usually favorable. Rifampicin-induced AIN is observed in two circumstances, either during intermittent treatment or when previous treatment is resumed. Macroscopic hematuria is rare and RI often severe. Anti-rifampicin anti-bodies are usually found. 2) ATIN due to direct toxicity. Several classes of antibiotics may be responsible: cephalosporins, polymyxins or cyclins, but it is usually observed with aminoglycosides (AG). The incidence of renal involvement due to the latter group is estimated to be 4 to 10%. Nephrotoxicity is initially reflected by polyuria, tubular proteinuria and increased enzymuria, followed by cylindruria and reduced glomerular filtration. HD is rarely required. The proximal tubule is predominantly affected; pathological findings are disappearance of the brush border and tubular necrosis. Electronic microscopy shows lysosomal alterations with numerous myelinic bodies. Tubular regeneration occurs within 15 to 30 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aminoglycosides; Anti-Bacterial Agents; Cephalosporins; Drug Hypersensitivity; Humans; Nephritis; Polymyxins; Rifampin; Tetracyclines

Topics: Clofazimine; Dapsone; Drug Hypersensitivity; Ethionamide; Humans; Leprostatic Agents; Leprosy; Rifampin; Thioacetazone

In a 48-years old woman, intermittent rifampicin treatment induced an immunoallergic reaction with digestive disorders, haemolysis, acute renal failure and prolonged prothrombin time. The reintroduction of rifampicin, 17 days later, resulted in a similar, though more severe, reaction associated with diffuse haemorrhages from disseminated intravascular coagulation, this association being exceptional. The responsibility of rifampicin was demonstrated by the chronological relationship between clinical symptoms and administration of the drug, and by the presence in the patient's serum of anti-rifampicin antibodies. The antigen-antibody reaction with complement activation and haemolysis probably explains the disseminated intravascular coagulation.

Topics: Acute Kidney Injury; Antibodies; Antigen-Antibody Reactions; Complement Activation; Disseminated Intravascular Coagulation; Drug Hypersensitivity; Female; Hemolysis; Humans; Middle Aged; Rifampin

In a 48-year-old man, a consistent pattern of spiking fever occurred ten days after the initiation of therapy with isoniazid and rifampin. The fever recurred upon rechallenge with isoniazid, but not with rifampin. Isoniazid has the potential to induce fever, and this is thought to be a hypersensitivity reaction.

Topics: Drug Hypersensitivity; Fever; Humans; Isoniazid; Male; Middle Aged; Rifampin; Time Factors

Topics: Drug Hypersensitivity; Humans; Male; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Adult; Drug Hypersensitivity; Humans; Male; Recurrence; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Antibodies; Drug Combinations; Drug Hypersensitivity; Female; Humans; Male; Rifampin; Trimethoprim

A 28-year-old woman suffering from diabetes, malabsorption and pulmonary tuberculosis was treated successfully with ethambutol and rifampicin intravenously for 4 months. The drugs were given through a catheter placed in the upper caval vein. One month after the treatment was started the sputum cultures became negative. During oral therapy the patient suffered from characteristic "flu" syndrome which surprisingly disappeared during the intravenous treatment. The possible causes are discussed. Allergic reactions to rifampicin appeared among the staff. The results of the allergological examinations are mentioned and directions for handling rifampicin powder are suggested.

Topics: Adult; Dermatitis, Occupational; Drug Hypersensitivity; Female; Humans; Infusions, Parenteral; Medical Staff, Hospital; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Adult; Aged; Cell Migration Inhibition; Drug Hypersensitivity; Humans; In Vitro Techniques; Leukocytes; Middle Aged; Penicillins; Rifampin

Topics: Antitubercular Agents; Drug Hypersensitivity; Drug Tolerance; Humans; Isoniazid; Pyrazinamide; Rifampin; Streptomycin

Topics: Abdomen, Acute; Adolescent; Adult; Anaphylaxis; Drug Hypersensitivity; Female; Humans; Male; Middle Aged; Rifampin; Streptomycin

Intrathecal vancomycin and oral rifampin have been used together to successfully treat a patient with enterococcal meningitis who was allergic to penicillin and who had failed a course of treatment with chloramphenicol. This therapy was tolerated very well and represents an alternate mode of therapy which should be considered in penicillin allergic patients with enterococcal meningitis.

Topics: Administration, Oral; Chloramphenicol; Drug Hypersensitivity; Drug Therapy, Combination; Humans; Injections, Spinal; Male; Meningitis; Middle Aged; Penicillins; Rifampin; Streptococcal Infections; Vancomycin

Topics: Adolescent; Adult; Aged; Antitubercular Agents; Drug Administration Schedule; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Middle Aged; Pyrazinamide; Rifampin; Streptomycin; Time Factors; Tuberculosis, Pulmonary

Topics: Antitubercular Agents; Chemical and Drug Induced Liver Injury; Drug Eruptions; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Hematologic Diseases; Humans; Isoniazid; Liver; Peripheral Nervous System Diseases; Psychoses, Substance-Induced; Rheumatic Diseases; Rifampin; Streptomycin; Tuberculosis

Topics: Drug Hypersensitivity; Humans; Rifampin

Although short-course, largely twice weekly chemotherapy for treatment of tuberculosis has been shown to be effective in other countries, when given under closely controlled conditions, it has not been adopted in this country where most patients are older and are treated as outpatients. Since January, 1976, 315 patients (mean age 55.5 years) with proven pulmonary tuberculosis have been treated with rifampin (RIF) 600 mg and isoniazid (INH) 300 mg daily for one month, followed by RIF 600 mg and INH 900 mg twice-weekly for another eight months, self-administered except for a few patients. By three months, 95 percent had converted to negative culture. There were only ten failures among 185 patients in whom final results could be assessed. There has been only one relapse during 1-21 months of follow-up in 175 patients. Serious side effects were few: six instances of jaundice, two of "flu-like syndrome," and one of thrombocytopenia. This form of initial therapy for tuberculosis is safe, effective, and economical.

Topics: Adolescent; Adult; Aged; Drug Hypersensitivity; Humans; Isoniazid; Jaundice; Middle Aged; Rifampin; Thrombocytopenia; Time Factors; Tuberculosis, Pulmonary; Vomiting

Topics: Acute Kidney Injury; Antigen-Antibody Complex; Contraceptives, Oral; Drug Hypersensitivity; Drug Interactions; Humans; Liver; Methods; Rifampin

Topics: Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Drug Synergism; Humans; Rifampin; Thrombocytopenia; Tuberculin Test

The immunohistological findings in 10 cases of DIHN and in 6 cases of R-ARF were compared with the patterns of experimental models and human examples of immunological nephritis. In most cases the simultaneous involvement of glomerular and extraglomerular structures was observed. A linear pattern on tubules together with a granular pattern on glomeruli and other structures was more frequently seen in Rifampicin adverse reactions. Direct and indirect immunofluorescence techniques performed in these last cases gave no evidence of the presence of the antigen and specific antibodies in the kidneys.

Topics: Adult; Aged; Animals; Basement Membrane; Drug Hypersensitivity; Female; Fluorescent Antibody Technique; Humans; Kidney; Kidney Glomerulus; Kidney Tubules; Male; Middle Aged; Nephritis; Nephritis, Interstitial; Rats; Rifampin; Sulfonamides

Topics: Acute Kidney Injury; Drug Hypersensitivity; Humans; Kidney Glomerulus; Kidney Tubules; Male; Middle Aged; Rifampin

Topics: Adult; Anaphylaxis; Drug Hypersensitivity; Humans; Male; Rifampin; Tuberculosis, Pulmonary

Starting again a Rifampicin treatment gave rise to an acute renal insufficiency, reversible by hemodialysis. This incident resulted from an immunopathological conflict revealed by the presence of anti-Rifampicin antibodies. Renal needle biopsy did not show any immune deposits. The mechanism of these incidents is discussed. Authors draw attention to the necessity of avoiding discontinuous Rifampicin treatment.

Topics: Acute Kidney Injury; Biopsy, Needle; Drug Hypersensitivity; Female; Humans; Kidney Tubules; Middle Aged; Nephritis; Renal Dialysis; Rifampin

From 8 cases of immuno-allergic accidents attributed to Rifampicine, the authors review the literature on the subject. The "flue like" syndrome is the most frequent and characteristic of those accidents, worsened by haematological and renal involvements. These accidents probably belong to a pathology of immuno-complexes in relaiton with the production of anti-Rifampicine antibodies. Among the different means of in vitro diagnosis, the test with the anti-complement antiglobulin is the most reliable, though not always in good correlation with clinical signs. Though rare and most often benign, these accidents should lead to prudence in treating recurrent tuberculosis or reusing Rifampicine after a momentary interruption.

Topics: Aged; Antibodies; Drug Hypersensitivity; Female; Humans; Purpura, Thrombocytopenic; Respiratory Tract Diseases; Rifampin; Skin Diseases; Tuberculosis, Pulmonary

In sera of patients treated with rifampicin, who had episodes ascribable to rifampicin sensitization, IgE antibodies were found. These antibodies cross-react with rifamycin SV and with the chromophoric moiety of rifamycins, but not with the side chain of rifampicin.

Topics: Antibodies; Drug Hypersensitivity; Histamine Release; Humans; Immunoglobulin E; Rifampin; Rifamycins

Topics: Adult; Cell Migration Inhibition; Drug Hypersensitivity; Female; Humans; Leukocytes; Macrophage Migration-Inhibitory Factors; Male; Middle Aged; Rifampin

A large number of chemical agents, administered for therapeutic or diagnostic purposes, can produce various types of hepatic injury by several mechanisms. Some agents are intrinsically hepatotoxic, and others produce hepatic injury only in the rare, uniquely susceptible individual. Idiosyncrasy of the host is the mechanism for most types of drug-induced hepatic injury. It may reflect allergy to the drug or a metabolic aberation of the host permitting the accumulation of hepatotoxic metabolites. The syndromes of hepatic disease produced by drugs have been classified hepatocellular, hepatocanalicular, mixed and canalicular. Measurement of serum enzyme activities has provided a powerful tool for studies of hepatotoxicity. Their measurement requires awareness of relative specificity, knowledge of the mechanisms involved, and knowledge of the relationship between known hepatotoxic states and elevated enzyme activities.

Topics: Anti-Bacterial Agents; Anticonvulsants; Antidepressive Agents; Antineoplastic Agents; Chemical and Drug Induced Liver Injury; Clinical Enzyme Tests; Contraceptives, Oral, Hormonal; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Ethanol; Female; Humans; Liver Diseases; Mitochondria, Liver; Rifampin; Steroids; Tetracycline; Tranquilizing Agents

Topics: Adult; Drug Hypersensitivity; Female; Humans; Rifampin; Stomach Diseases

Topics: Acute Kidney Injury; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Hemolysis; Humans; Liver; Rifampin; Tuberculosis, Pulmonary

Topics: Aminosalicylic Acids; Animals; Antitubercular Agents; Capreomycin; Chemical and Drug Induced Liver Injury; Cycloserine; Deafness; Drug Hypersensitivity; Ethambutol; Ethionamide; Gastrointestinal Diseases; Goiter; Humans; Isoniazid; Kanamycin; Liver; Mental Disorders; Mice; Nervous System Diseases; Pyrazinamide; Rifampin; Streptomycin; Thioacetazone; Tuberculosis; Viomycin

Topics: Adult; Aged; Drug Hypersensitivity; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Mycobacterium tuberculosis; Rifampin; Tuberculosis, Pulmonary

Drug-induced hypersensitivity nephritis may show several histological and clinical patterns. In most of these microscopic vascular involvement of the kidney seems to be very frequent. On immunofluorescence, deposits of C3 in mesangium and in arterioles were observed in almost all cases, independently of histological features on light microscopy. The pointing out of clinico-histological relationship seems to be the best rational approach to diagnosis of these conditions.

Topics: Adult; Aged; Ampicillin; Complement C3; Complement C4; Drug Hypersensitivity; Female; Fluorescent Antibody Technique; Glomerulonephritis; Humans; Immunoglobulin G; Immunoglobulin M; Kidney Glomerulus; Male; Methicillin; Middle Aged; Nephritis; Nephritis, Interstitial; Rifampin

Topics: Child; Child, Preschool; Drug Hypersensitivity; Drug Interactions; Drug Therapy, Combination; Humans; Infant; Isoniazid; Pyrazinamide; Rifampin; Streptomycin; Tuberculosis, Meningeal

Topics: Adult; Aged; Drug Hypersensitivity; Ethambutol; Female; Humans; Male; Middle Aged; Protein Binding; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Drug Hypersensitivity; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Age Factors; Animals; Cycloserine; Cytoplasmic Granules; Dextrans; Drug Hypersensitivity; Histamine Release; Humans; Hydrogen-Ion Concentration; Immunoglobulin E; In Vitro Techniques; Insulin; Lidocaine; Mast Cells; Penicillins; Rats; Rifampin

Topics: Aminosalicylic Acids; Cell Migration Inhibition; Drug Hypersensitivity; Drug Therapy, Combination; Humans; Immunity, Cellular; In Vitro Techniques; Isoniazid; Macrophages; Rifampin; Tuberculosis, Lymph Node; Tuberculosis, Meningeal; Tuberculosis, Pulmonary; Tuberculosis, Renal

Topics: Capreomycin; Cells, Cultured; Chemical and Drug Induced Liver Injury; Cycloserine; Depression; Drug Hypersensitivity; Drug Resistance, Microbial; Drug Therapy, Combination; Ethambutol; Follow-Up Studies; Hospitalization; Humans; Isoniazid; Kanamycin; Kidney Diseases; Optic Neuritis; Patient Education as Topic; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Anuria; Biopsy; Creatinine; Drug Hypersensitivity; Humans; Male; Middle Aged; Rifampin; Time Factors; Tuberculosis, Pulmonary; Uric Acid

Topics: Aminosalicylic Acids; Antitubercular Agents; Arthritis; Chemical and Drug Induced Liver Injury; Child; Cycloserine; Drug Hypersensitivity; Drug Resistance, Microbial; Ethambutol; Ethionamide; Humans; Isoniazid; Kanamycin; Liver; Lupus Vulgaris; Male; Middle Aged; Pyrazinamide; Rifampin; Streptomycin; Tuberculin Test; Tuberculosis; Viomycin

Topics: Antitubercular Agents; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Humans; Rifampin; Tuberculosis

Topics: Acute Kidney Injury; Antibodies; Dose-Response Relationship, Drug; Drug Hypersensitivity; Hemorrhagic Disorders; Humans; Respiratory Insufficiency; Rifampin; Tuberculosis, Pulmonary

Five out of 200 patients taking rifampicin 900 mg twice weekly and three out of 91 patients taking rifampicin who attended an immunology clinic developed intolerance to the drug. Antibodies to rifampicin, which were found in most cases, decreased steadily after the end of treatment but were detectable for up to 16 months. The dose of rifampicin and the blood levels are predominating factors in the occurrence of reactions. Thus the dose should be reduced in patients in whom rifampicin blood levels rise abnormally. When it is important to continue rifampicin treatment despite intolerance antibody titres within 24 hours after administration of the drug must be measured to find when they are lowest, which determines the "unreactive period," and when a further dose may be safely given.

Topics: Antibodies; Antibody Formation; Binding Sites, Antibody; Biological Assay; Cell Membrane; Coombs Test; Dose-Response Relationship, Drug; Drug Hypersensitivity; Drug Tolerance; Erythrocytes; Humans; Isoniazid; Lymphocyte Activation; Rifampin; Time Factors; Tuberculosis

Topics: Acute Kidney Injury; Antibody Formation; Drug Hypersensitivity; Humans; Male; Middle Aged; Proteinuria; Rifampin; Specific Gravity; Tuberculosis, Pulmonary

Topics: Dose-Response Relationship, Drug; Drug Hypersensitivity; Hemolysis; Humans; Rifampin; Tuberculosis

Topics: Adult; Aged; Agranulocytosis; Anaphylaxis; Antitubercular Agents; Capreomycin; Cycloserine; Drug Hypersensitivity; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Kanamycin; Pyrazinamide; Rifampin; Thrombocytopenia; Viomycin

Topics: Aminosalicylic Acids; Antitubercular Agents; Cycloserine; Drug Hypersensitivity; Ethambutol; Ethionamide; Humans; Isoniazid; Kanamycin; Pyrazinamide; Pyridoxine; Rifampin; Sputum; Streptomycin; Tuberculosis; Viomycin

Topics: Adult; Biopsy, Needle; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Drug Tolerance; Female; Hepatitis A; Humans; Isoniazid; Jaundice; Liver; Male; Middle Aged; Rifampin; Tuberculosis

Topics: Acute Kidney Injury; Anti-Bacterial Agents; Cephalexin; Cephaloridine; Cephalothin; Drug Hypersensitivity; Gentamicins; Humans; Kanamycin; Kidney Diseases; Kidney Tubules; Nephritis; Nephritis, Interstitial; Penicillins; Polyenes; Polymyxins; Rifampin

Topics: Adult; Aged; Aminosalicylic Acids; Drug Combinations; Drug Hypersensitivity; Female; Humans; Isoniazid; Male; Middle Aged; Purpura; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Aminosalicylic Acids; Antitubercular Agents; Blood Sedimentation; Drug Hypersensitivity; Ethambutol; Female; Humans; Isoniazid; Leukocyte Count; Lymphocytes; Male; Middle Aged; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Topics: Acute Disease; Acute Kidney Injury; Adult; Ambulatory Care; Amylases; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Hematologic Diseases; Humans; Isoniazid; Liver; Male; Pancreatitis; Prednisolone; Recurrence; Rifampin; Stimulation, Chemical; Streptomycin; Transaminases; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Anuria; Drug Hypersensitivity; Fibrinogen; Fluorescent Antibody Technique; Furosemide; Humans; Immunoglobulins; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Dexamethasone; Drug Hypersensitivity; Ethambutol; Glomerular Filtration Rate; Humans; Isoniazid; Pleural Effusion; Pyridoxine; Rifampin; Tuberculosis, Pulmonary; Tuberculosis, Spinal

Topics: Acute Kidney Injury; Antibodies; Drug Hypersensitivity; Humans; Male; Middle Aged; Recurrence; Rifampin; Tuberculosis, Pulmonary

Topics: Administration, Oral; Aminosalicylic Acids; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Rifampin; Time Factors; Tuberculosis

Topics: Adult; Antibodies; Antibody Formation; Drug Hypersensitivity; Female; Humans; Male; Middle Aged; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Adult; Antitubercular Agents; Drug Hypersensitivity; Ear; Ethambutol; Female; Humans; Isoniazid; Liver; Male; Polyneuropathies; Rifampin; Streptomycin; Thrombocytopenia

Topics: Bilirubin; Drug Eruptions; Drug Hypersensitivity; Ethambutol; Humans; Isoniazid; Mycobacterium tuberculosis; Recurrence; Rifampin; Sputum; Transaminases; Tuberculosis, Pulmonary

Topics: Adult; Aminosalicylic Acids; Antitubercular Agents; Cycloserine; Drug Hypersensitivity; Drug Resistance, Microbial; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Kanamycin; Male; Middle Aged; Neomycin; Oxytetracycline; Rifampin; Streptomycin; Thiosemicarbazones; Viomycin

Topics: Acute Kidney Injury; Adult; Drug Hypersensitivity; Humans; Jaundice; Male; Rifampin; Thrombocytopenia

Topics: Adolescent; Anemia, Hemolytic; Antibody Specificity; Drug Hypersensitivity; Female; Humans; Immunoglobulin G; Quinine; Rifampin

Topics: Alkaline Phosphatase; Bilirubin; Blood Proteins; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Drug Synergism; Female; Humans; Isoniazid; Liver; Liver Function Tests; Male; Rifampin; Transaminases; Tuberculosis, Pulmonary

Topics: Antigen-Antibody Reactions; Cortisone; Drug Hypersensitivity; Female; Humans; Hydrocortisone; Knee; Male; Middle Aged; Prednisolone; Rifampin; Salpingitis; Tuberculosis, Female Genital; Tuberculosis, Osteoarticular

Topics: Antigen-Antibody Reactions; Bilirubin; Drug Hypersensitivity; Humans; Liver; Rifampin; Time Factors; Transaminases; Tuberculosis

Topics: Adolescent; Adult; Aged; Bilirubin; Chemical and Drug Induced Liver Injury; Drug Eruptions; Drug Hypersensitivity; Ethambutol; Female; Humans; Isoniazid; Male; Middle Aged; Rifampin; Transaminases

Topics: Aminosalicylic Acids; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Cycloserine; Drug Eruptions; Drug Hypersensitivity; Drug Resistance, Microbial; Drug Synergism; Ethambutol; Ethionamide; Female; Gastrointestinal Diseases; Humans; Hypothyroidism; Isoniazid; Kanamycin; Male; Microbial Sensitivity Tests; Pyrazinamide; Recurrence; Rifampin; Streptomycin; Tuberculosis, Pulmonary; Viomycin

Topics: Aminocaproates; Asthenia; Drug Hypersensitivity; Female; Fever; Gastrointestinal Diseases; Headache; Humans; Middle Aged; Rifampin; Thrombocytopenia; Tuberculosis, Pulmonary; Vertigo

Topics: Adult; Aged; Drug Hypersensitivity; Female; Humans; Male; Middle Aged; Purpura, Thrombocytopenic; Rifampin; Thrombocytopenia; Tuberculosis, Pulmonary

Topics: Adult; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Contraceptives, Oral; Drug Hypersensitivity; Drug Tolerance; Female; Humans; Kidney Function Tests; Rifampin; Tuberculosis; Uterine Hemorrhage; Vision Disorders

Topics: Administration, Oral; Drug Hypersensitivity; Gonorrhea; Humans; Male; Penicillin Resistance; Rifampin; Urethritis

Topics: Adult; Drug Hypersensitivity; Humans; Male; Rifampin; Tuberculosis, Pulmonary