rifampin and Intestinal-Diseases

Clofazimine enterophathy is a serious complication of clofazimine when used at high doses for treatment of type 2 lepra or or erythema nodosum leprosum. Objective. A woman is presented who had a delayed diagnosis of leprosy, persistent type 2 lepra reaction and lethal clofazimine enteropathy.. A 31-year-old woman presented leprosy symptoms over a 16-year period without medical diagnosis of her disease. During this period, type 2 lepra episodes occurred, but were not accurately diagnosed. These episodes became more severe during her second pregnancy. The patient and her family were interviewed, and her clinical history reviewed.. After twelve years of medical consults, lepromatous leprosy was diagnosed, based on perforation of her nasal septum, with a bacterial index of 5. Her husband and a 12-year-old daughter have leprosy symptoms. During multidrug therapy, she presented with repeated type 2 lepra reaction episodes for which she received daily clofazimine 400 mg doses. Two months after this treatment, severe and frequent episodes of intense abdominal pain began to occur. These persisted for more than a year and were managed with in-hospital administration of several classes of painkillers and antispasmodic medication, including morphine. She also presented with sporadic diarrhea, constipation, nausea, weight loss and mesenteric adenopathies. She died finally due to this intestinal condition. No autopsy was performed.. The patient's clinical presentation suggested a clofazimine-induced lethal enteropathy, a complication not previously seen in Colombia. This connection was not recognized by the medical officers that treated the patient.

Topics: Abdominal Pain; Adult; Arthritis, Rheumatoid; Child; Child, Preschool; Clofazimine; Constipation; Diagnostic Errors; Diarrhea; Drug Therapy, Combination; Erythema Nodosum; Family Health; Fatal Outcome; Female; Humans; Intestinal Diseases; Leishmaniasis, Mucocutaneous; Leprostatic Agents; Leprosy, Lepromatous; Male; Paresthesia; Pregnancy; Pregnancy Complications, Infectious; Rifampin

This study aimed at making a comparative assessment of the growth of pure cultures of Human Intestinal Spirochaetes (HIS) in a control medium without antibiotics and in media including antibiotics (spectinomycin, rifampin, colistin, polymyxin B, amphotericin B, vancomycin, spiramycin) whose use had been indicated in the literature in connection with the isolation of HIS or animal intestinal spirochaetes. All the strains of HIS tested grew in media to which appropriate concentrations of those drugs had been added giving a final number of CFU/ml +/- 10 times the number of CFU/ml observed in the control medium. These results indicate that a selective medium to be used for the isolation of HIS may include appropriate concentrations of one or more of the following antibiotics: spectinomycin (100-1,000 micrograms/ml), rifampin (10-30 micrograms/ml), vancomycin (6.25 micrograms/ml), colistin (6.25 micrograms/ml), polymyxin B (5 micrograms/ml), spiramycin (1-10 micrograms/ml) and amphotericin B (0.05-35 micrograms/ml).

Topics: Adult; Aged; Amphotericin B; Anti-Bacterial Agents; Antibiotics, Antitubercular; Antifungal Agents; Bacteriological Techniques; Child, Preschool; Colistin; Culture Media; Female; Humans; Intestinal Diseases; Male; Microbial Sensitivity Tests; Middle Aged; Polymyxin B; Rifampin; Spectinomycin; Spiramycin; Spirochaetales; Vancomycin

The growth of pure cultures of 24 human intestinal spirochaetes (HIS) was analysed comparatively in six selective media with antibiotics and in a control medium without antibiotics. The selective media SR and SP were the only two media among the six tested which allowed the growth of all the strains studied. These media contained spectinomycin (400 micrograms/ml) and rifampin (30 micrograms/ml) (SR), and spectinomycin (400 micrograms/ml) and polymyxin B (5 micrograms/ml) (SP), respectively. Moreover, most of the strains tested showed in these two media a number of CFU/ml equal to, or, for a few strains, not more than ten-fold lower than that observed in the control medium. The other four selective media tested were: SRVC (spectinomycin 200 micrograms/ml; rifampin 12.5 micrograms/ml; vancomycin 6.25 micrograms/ml; colistin 6.25 micrograms/ml), CSp (colistin 6.25 micrograms/ml; spiramycin 25 micrograms/ml), SRSp (spectinomycin 200 micrograms/ml; rifampin 12.5 micrograms/ml; spiramycin 25 micrograms/ml) and SRVCSp (spectinomycin 200 micrograms/ml; rifampin 12.5 micrograms/ml; vancomycin 6.25 micrograms/ml; colistin 6.25 micrograms/ml; spiramycin 25 micrograms/ml). The growth of most of the spirochaetes was strongly reduced in the media SRVC, CSp, SRSp and SRVCSp. Furthermore, several of the 24 HIS examined did not grow in the medium SRVC (3 spirochaetes, 11%), CSp (15 spirochaetes, 62%), SRSp (17 spirochaetes, 70%), SRVCSp (19 spirochaetes, 79%). The results reported in this paper indicate that the media SR and SP, of the six selective media tested, may profitably be used in the isolation of HIS as they did not significantly affect the growth of the HIS tested.

Topics: Anti-Bacterial Agents; Antifungal Agents; Bacteriological Techniques; Culture Media; Drug Therapy, Combination; Humans; Intestinal Diseases; Polymyxin B; Rifampin; Spectinomycin; Spirochaetales

It was shown that long-term oral administration of rifampicin (40 mg/kg) to rats was accompanied by a marked decrease in the number of enterococci and staphylococci in their large intestine. A significant decrease in the number of colibacilli and anaerobic nonsporulating gramnegative bacteria was also observed. Discontinuation of the antibiotic administration resulted in rapid recovery of the intestinal flora with respect to all the indices tested. It was found for the first time that pregany of rats with experimental disbacteriosis was characterized by lowered colon resistance in spite of similarity in the intestinal flora of the experimental and control pregany. This was evident from increased periods of indicator microorganism retention in the animal intestine.

Topics: Animals; Animals, Newborn; Bacteria; Bacterial Infections; Feces; Female; Intestinal Diseases; Intestine, Large; Pregnancy; Prenatal Exposure Delayed Effects; Rats; Rats, Inbred Strains; Rifampin; Time Factors

Topics: Bacteroides; Bacteroides Infections; Clindamycin; Culture Media; Drug Evaluation; Drug Resistance, Microbial; Drug Synergism; Humans; Intestinal Diseases; Lincomycin; Metronidazole; Rifampin; Surgical Wound Infection; Tetracycline