rifampin and Enterocolitis--Necrotizing

This study aims to examine the use and safety of rifampin in the hospitalized infants.. Observational study of clinical and laboratory adverse events among infants exposed to rifampin from 348 neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2012.. Overall, 2,500 infants received 4,279 courses of rifampin; mean gestational age was 27 weeks (5th, 95th percentile; 23, 36) and mean birth weight was 1,125 g (515; 2,830). Thrombocytopenia (121/1,000 infant days) and conjugated hyperbilirubinemia (25/1,000 infant days) were the most common laboratory adverse events. The most common clinical adverse events were medical necrotizing enterocolitis (64/2,500 infants, 3%) and seizure (60/2,500 infants, 2%).. The overall incidence of adverse events among infants receiving rifampin appears low; however, additional studies to further evaluate safety and dosing of rifampin in this population are needed.

Topics: Antibiotics, Antitubercular; Birth Weight; Enterocolitis, Necrotizing; Female; Gestational Age; Hospitalization; Humans; Hyperbilirubinemia; Infant; Infant, Extremely Premature; Infant, Newborn; Infant, Very Low Birth Weight; Intensive Care Units, Neonatal; Male; Rifampin; Seizures; Thrombocytopenia

We report a case of pseudomembranous colitis that developed in a patient with liver cirrhosis during anti-tuberculosis therapy with rifampicin and isoniazid. The association between rifampicin and pseudomembranous colitis has been controversial; this report, however, supports the association. Colonoscopy performed 3 days after the onset of the pseudomembranous colitis revealed only reddish patches and a few aphthoid lesions, but 4 days later pseudomembranes were apparent. The pseudomembranous colitis was successfully controlled by discontinuation of the anti-tuberculosis agents, along with the administration of lactic acid bacteria, without vancomycin or metronidazole. Possible predisposing factors for the development of pseudomembranous colitis in this patient are also discussed.

Topics: Antibiotics, Antitubercular; Biopsy; Colonoscopy; Enterocolitis, Necrotizing; Female; Humans; Intestinal Mucosa; Middle Aged; Rifampin; Risk Factors; Tuberculosis, Pulmonary