rifampin and Keratitis

A controlled chemotherapy trial of trachoma was carried out in a Tunisian oasis among schoolchildren with active disease. We compared 1% tetracycline ointment (79 patients) or 1% rifampicin ointment (76 patients) with 5% boric acid ointment (79 patients). Medications were administered twice daily, six days a week, for ten weeks. Slit-lamp examinations by three ophthalmologists were made independently before treatment as well as five, 19, and 39 weeks after treatment. Bacteriologic cultures were taken during treatment as were smears to detect trachoma agent at each clinical examination. Five weeks after treatment, the intensity of conjunctival disease in the tetracycline and rifampicin groups was reduced significantly when compared with boric acid, but at 19 weeks this suppression was found only in the tetracycline group. Ocular bacterial pathogens were eliminated almost entirely in the two antibiotic groups during treatment. The initial prevalence of trachoma (29to 31%) was significantly reduced in the two antibiotic-treated groups at five weeks and 19 weeks after treatment. The prevalence of trachoma was equally low (7%) in all three groups following retreatment with tetracycline. Although both antibiotics were effective, rifampicin offered no advantage over tetracycline in this trial. Recurrent disease in this school-based treatment study probably was due to reinfection from younger siblings at home. While systematic, community-wide, antibiotic treatment programs are not always possible in countries where trachoma is endemic, limited antibiotic therapy programs should be continued in these areas to reduce the intensity and prevalence of trachoma, even though the disease cannot be eradicated.. In this study, the authors compared topically applied tetracycline or rifampicin ointment with boric acid ointment administered for 10 weeks for its effect on endemic trachoma. 234 children with active disease were included in the treatment study. Those with the active disease were divided into 2 groups containing equal numbers each of the 3 intensity categories. Then each group was assigned to 1 of 3 treatment categories. Medication was administered twice daily over a single 3-hour class period and a 70-day course of follow-up therapy with 1% tetracycline was provided once daily for all the children 25 weeks after completion of the initial treatment. 62 (26.5%) had severe trachoma and 133 (56.8%) had trachoma of moderate intensity. In March 1972, 5 weeks after treatment completion, the trachoma in the 2 groups treated with antibiotics was less severe compared with the boric acid group. However, by June 1972, only the tetracycline group had less active trachoma than the boric acid treated group. By this time, also, the 3 groups were equally improved. Following the 2nd course of tetracycline treatment 25-35 weeks after the initial trial, there were no differences in any of the groups. 2 courses of therapy, therefore, were no more advantageous than 1. In Giemsa-stained smears prior to treatment, the prevalence of positive smears for Chlamydia agent were similar in the 3 groups; following treatment, prevalence had dropped to 7% overall and then after retreatment, there were rarely any cases in any of the treated groups. While the 2 antibodies were significantly better than boric acid, rifampicin did not seem to offer any significant advantages over tetracycline. The prevalence of trachoma agent appeared to change more readily than the clinical disease. Clearly the pattern of disease intensity and microbial infection displayed a seasonal cycle thatmust be considered when evaluating antibiotic treatment efficacy. The prevalence of trachoma decreases with age and that, along with the seasonality, contribute to the disease intensity. In this study, treatment did alter the disease temporarily but did not affect its course in the long run since environmental factors which originally produced the disease had not changed. Only communitywide chemotherapy would have a significant effect. However, antibiotic treatment is necessary to reduce the occurrence of later complications.

Topics: Administration, Topical; Animals; Boric Acids; Child; Chlamydia; Clinical Trials as Topic; Conjunctiva; Humans; Keratitis; Ointments; Rifampin; Sheep; Tetracycline; Trachoma; Tunisia

Topics: Aged; Animals; Aqueous Humor; Cataract; Clinical Trials as Topic; Conjunctivitis; Cornea; Dacryocystitis; Eye Diseases; Glaucoma; Humans; Iritis; Keratitis; Middle Aged; Rabbits; Retinal Detachment; Retinitis; Rifampin; Uveitis, Anterior; Vitreous Body

Pseudomonas aeruginosa is a leading cause of corneal infections. Recently, we discovered an antimicrobial drug combination, polymyxin B/trimethoprim (PT) + rifampin, that displayed impressive efficacy toward P. aeruginosa in both in vitro and in vivo studies. As such, this combination was further evaluated as a potential keratitis therapeutic through testing the combination's efficacy against a diverse set of P. aeruginosa clinical isolates.. Minimum inhibitory concentrations (MICs) of moxifloxacin, levofloxacin, erythromycin, tobramycin, PT, polymyxin B (alone), trimethoprim (alone), and rifampin were determined for 154 ocular clinical P. aeruginosa isolates, 90% of which were derived from corneal scrapings. Additionally, the efficacy of PT + rifampin was evaluated utilizing fractional inhibitory concentration (FIC) testing.. While 100% of isolates were resistant to erythromycin (average MIC 224 ± 110 µg·mL-1) and trimethoprim (alone) (206 ± 67.3 µg·mL-1), antibiotic resistance was generally found to be low: moxifloxacin (2% of isolates resistant; average MIC 1.08 ± 1.61 µg·mL-1), levofloxacin (3.9%; 1.02 ± 2.96 µg·mL-1), tobramycin (1%; 0.319 ± 1.31 µg·mL-1), polymyxin B (0%; 0.539 ± 0.206 µg·mL-1), PT (0%; 0.416 ± 0.135 µg·mL-1), and rifampin (0%; 23.4 ± 6.86 µg·mL-1). Additionally, FIC testing revealed that PT + rifampin eradicated 100% of isolates demonstrating additive or synergistic activity in 95% of isolates (average FIC index 0.701 ± 0.132).. The drug combination of PT + rifampin was effective against a large panel of clinically relevant P. aeruginosa strains and, as such, may represent a promising therapeutic for P. aeruginosa keratitis.. This work furthers the preclinical development of a novel antibiotic combination for the treatment of corneal infections (bacterial keratitis).

Topics: Anti-Bacterial Agents; Bacitracin; Drug Combinations; Erythromycin; Framycetin; Humans; Keratitis; Levofloxacin; Moxifloxacin; Polymyxin B; Pseudomonas aeruginosa; Pseudomonas Infections; Rifampin; Tobramycin; Trimethoprim

Brucellosis is a zoonotic disease caused by brucella. It has been an increasing trend in recent years (Wang H, Xu WM, Zhu KJ, Zhu SJ, Zhang HF, Wang J, Yang Y, Shao FY, Jiang NM, Tao ZY, Jin HY, Tang Y, Huo LL, Dong F, Li ZJ, Ding H, Liu ZG, Emerg Microbes Infect 9:889-99, 2020). Brucellosis is capable to invade multiple systems throughout the body, lacking in typical clinical manifestations, and easily misdiagnosed and mistreated.. We report a case of a male, 5-year-and-11-month old child without relevant medical history, who was admitted to hospital for 20 days of fever. When admitted to the hospital, we found that he was enervated, irritable and sleepy, accompanied with red eyes phenomenon. After anti-infection treatment with meropenem, no improvement observed. Lumbar puncture revealed normal CSF protein, normal cells, and negative culture. Later, doppler echocardiography suggested coronary aneurysms, and incomplete Kawasaki Disease with coronary aneurysms was proposed. The next day, brucellosis agglutination test was positive. Metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid suggested B.melitensis, which was confirmed again by blood culture. The child was finally diagnosed as brucellosis with meningocephalitis, coronary aneurysm and keratitis. According to our preliminary research and review, such case has never been reported in detail before. After diagnosis confirmation, the child was treated with rifampicin, compound sulfamethoxazole, and ceftriaxone for cocktail anti-infection therapy. Aspirin and dipyridamole were also applied for anticoagulant therapy. After medical treatment, body temperature of the child has reached normal level, eye symptoms alleviated, and mental condition gradually turned normal. Re-examination of the doppler echocardiographic indicated that the coronary aneurysm was aggravated, so warfarin was added for amplification of anticoagulation treatment. At present, 3 months of follow-up, the coronary artery dilatation gradually assuaged, and the condition is continued to alleviate.. Brucellosis can invade nervous system, coronary artery, and cornea. Brucellosis lacks specific signs for clinical diagnosis. The traditional agglutination test and the new mNGS are convenient and effective, which can provide the reference for clinical diagnosis.

Topics: Agglutination Tests; Animals; Anti-Infective Agents; Anticoagulants; Brucella melitensis; Brucellosis; Ceftriaxone; Child, Preschool; Coronary Aneurysm; Diagnostic Errors; Fever; Humans; Keratitis; Male; Meningoencephalitis; Rifampin; Sulfamethoxazole; Treatment Outcome; Zoonoses

Topics: Animals; Anti-Bacterial Agents; Cornea; Disease Models, Animal; Drug Resistance, Multiple, Bacterial; Drug Synergism; Drug Therapy, Combination; Eye Infections, Bacterial; Female; Humans; Keratitis; Mice; Mice, Inbred BALB C; Moxifloxacin; Ophthalmic Solutions; Polymyxin B; Pseudomonas aeruginosa; Pseudomonas Infections; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome; Trimethoprim

Bacterial keratitis causes significant blindness, yet antimicrobial resistance has rendered current treatments ineffective. Polymyxin B-trimethoprim (PT) plus rifampin has potent

Topics: Animals; Anti-Bacterial Agents; Cornea; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Eye Infections, Bacterial; Female; Keratitis; Mice; Mice, Inbred C57BL; Microbial Sensitivity Tests; Polymyxin B; Pseudomonas aeruginosa; Pseudomonas Infections; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Trimethoprim

To investigate causes and clinical findings of non-tuberculous mycobacterial keratitis, and to study its response to topical antibiotic therapy and surgical extirpative keratectomy.. A single centre, retrospective review of 22 patients with non-tuberculous mycobacterial keratitis seen in a 3 year period. Laboratory diagnoses were established with Ziehl-Nielsen acid fast staining and Löwenstein-Jensen cultures.. In 20 patients (91%), there was an antecedent history of foreign body eye trauma (18 patients) or elective surgery (two patients). There were 19 cases of Mycobacterium chelonei, and three of M fortuitum. Clinical signs included epithelial defects, satellite or ring stromal infiltrates, crystalline keratopathy, and hypopyon. For topical antibiotic therapy, 20 patients received amikacin, while one patient received rifampin and another received ciprofloxacin, each in accordance with the results of the in vitro drug sensitivities. An extirpative keratectomy was performed in 15 cases; four of these cases additionally required a temporary conjunctival flap in order to finally eradicate the infection. At the end of the follow up period (median 18 months; range 3 months to 3 years) all eyes were stable and free of infection, with 19 (86%) having final visual acuities of 20/200 or better.. Early clinical recognition and prompt laboratory diagnosis, together with aggressive topical antibiotic therapy and early keratectomy, may shorten morbidity and improve the clinical outcome of non-tuberculous mycobacterial keratitis.

Topics: Adult; Aged; Amikacin; Anti-Bacterial Agents; Ciprofloxacin; Eye Injuries; Female; Follow-Up Studies; Humans; Keratitis; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium chelonae; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Postoperative Complications; Retrospective Studies; Rifampin; Treatment Outcome; Visual Acuity

Topics: Adult; Corneal Transplantation; Ethambutol; Eye Injuries; Humans; Keratitis; Male; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Rifampin; Scleral Diseases; Skin Tests

In four patients with an adult chlamydial ophthalmia small, marginal corneal abscesses were detected. These corneal abscesses were associated with unilateral papillary and follicular conjunctivitis and punctate keratitis. In these patients no bacteria was isolated from the abscesses, but Chlamydia trachomatis was isolated from materials collected from the abscesses and from the conjunctival swabbings. In addition all patients had microbiologically proved concomitant chlamydial genital infections. The clinical signs resolved after topical treatment with rifampicin or tetracycline eye ointment for six weeks or systemic treatment with tetracycline for two weeks. Because of concomitant chlamydial genital infection it is advisable to treat patients with adult chlamydial ophthalmia with systemic tetracycline and to refer these patients and their consorts for investigation and treatment of their genital infection.

Topics: Abscess; Adult; Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis, Inclusion; Corneal Diseases; Female; Humans; Keratitis; Male; Middle Aged; Rifampin; Tetracycline

A man in New York, New York, contracted keratitis caused by Acanthamoeba castellanii. The diagnosis was delayed because amoebae were not initially suspected as the infectious organism. The culture isolate and the amoebae in corneal sections were identified as A. castellanii by immunofluorescence using antiserum to plasma membranes of this species. With the rapid agar disk diffusion method, the amoebae were shown to e susceptible to pimaricin (0.5%) and resistant to greater than 1,000-micrograms/ml levels of paromomycin, polymyxin B-bacitracin-neomycin, acriflavine, 5-fluorocytosine, amphotericin B, gentamicin, and trimethoprim-sulfamethoxazole. The infection responded to treatment with pimaricin administered with several other drugs. This infection is the eighth case reported in the literature of acanthamoebic keratitis and emphasizes the need for clinicians to consider acanthamoebic infection in the differential diagnosis of eye infections that fail to respond to bacterial, fungal, and viral therapy.

Topics: Adult; Aged; Amoeba; Animals; Atropine; Dexamethasone; Female; Humans; Keratitis; Male; Mice; Microbial Sensitivity Tests; Middle Aged; Natamycin; Neomycin; New York City; Rifampin; Uracil

In a model of experimental Candida albicans keratitis in rabbits, treatment with a combination of amphotericin B and rifampin was compared with treatment with amphotericin B alone. Both modes of therapy substantially reduced the number of organisms in the cornea below the number in untreated control corneas. In the group treated with combined therapy, there were significantly fewer organisms in the cornea after three days of therapy than in the group treated with amphotericin B alone. The results of this study indicate that the treatment of C albicans keratitis in rabbits with combined amphotericin B and rifampin is more effective than treatment with amphotericin B alone.

Topics: Amphotericin B; Animals; Candidiasis; Drug Therapy, Combination; Female; Keratitis; Male; Rabbits; Rifampin

We tested the corneal penetration of rifampin in four vehicles: dimethylsulfoxide, polyethylene glycol, an ocular lubricant, and as rifampin ointment. We measured drug concentrations in the aqueous humor in rabbits after topical instillation of 1 and 2.5% rifampin according to two dosage schedules. Drug concentrations in the aqueous humor were bactericidal to Mycobacterium leprae. Since leprosy of the cornea, iris, and ciliary body may develop despite standard systemic bacteriostatic treatment, treatment of leprotic involvement of the anterior eye may be enhanced by intensive topical application of rifampin.

Topics: Administration, Topical; Animals; Aqueous Humor; Chlorobutanol; Ciliary Body; Cornea; Dimethyl Sulfoxide; Drug Administration Schedule; Drug Combinations; Iris; Keratitis; Lanolin; Leprosy; Mineral Oil; Mycobacterium leprae; Ointments; Petrolatum; Pharmaceutical Vehicles; Polyethylene Glycols; Rabbits; Rifampin; Uveal Diseases

Topics: Adrenal Cortex Hormones; Adult; Anti-Bacterial Agents; Cornea; Edema; Eye Foreign Bodies; Humans; Keratitis; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Ophthalmic Solutions; Ophthalmoscopy; Rifampin; Species Specificity; Visual Acuity

Topics: Animals; Bacteriological Techniques; Dimethyl Sulfoxide; Edetic Acid; Gentamicins; Keratitis; Proteus Infections; Rabbits; Rifampin

Topics: Animals; Conjunctiva; Diarrhea; Dimethyl Sulfoxide; Edetic Acid; Gentamicins; Keratitis; Male; Microbial Sensitivity Tests; Pseudomonas Infections; Rabbits; Rifampin; Solubility