rifampin and Nausea

Intracranial tuberculomas are rare yet lethal forms of tuberculosis. Diagnosis is often difficult because of its nonspecific symptoms and radiological findings.. This study aims to perform a literature review of multiple tuberculomas to improve disease recognition and management in immunocompetent patients along with presenting a case report on the topic.. Scopus, LILACS, Ovid MEDLINE and EMBASE.. Case reports and case series up to December 2018 in English, Spanish, and Portuguese focusing on intracranial tuberculomas in adult and pediatric immunocompetent patients. Data on presentation, diagnostic workup, and treatment was analyzed.. Cochrane Collaboration/Cochrane Handbook and PRISMA guidelines.. Twenty reports involving 21 patients were included. Most patients were male (57.14%). The average age at diagnosis was 26.9 ± 14.9 years. Headache was the most common presenting symptom (52.4%; 11/21), followed by motor weakness (47.6%; 10/21) and vomiting (23.8%; 5/21). MRI was the most used image technique (17/21). Most lesions occurring in the cerebral hemispheres (16/21); we found five or more lesions in 66.6% (14/21) of the patients. The majority treated with anti-tuberculous drugs resulted in a favorable outcome.. Immunocompetent patients living in TB endemic areas whose clinical evaluation and neuroimaging findings are compatible with tuberculoma should undergo anti-tubercular treatment despite a lack of bacteriological confirmation.

Topics: Antitubercular Agents; Blindness; Brain; Brain Diseases; Cerebellar Ataxia; Dexamethasone; Drug Therapy, Combination; Endemic Diseases; Ethambutol; Female; Glucocorticoids; Humans; Immunocompetence; Isoniazid; Magnetic Resonance Imaging; Nausea; Nystagmus, Pathologic; Peru; Pyrazinamide; Quadriplegia; Rifampin; Tomography, X-Ray Computed; Tuberculoma, Intracranial; Tuberculosis, Pulmonary; Vomiting; Young Adult

Pyrazinamide, an antituberculous drug discovered in 1952, was first considered as a toxic drug. As it appeared as a bactericidal drug for the organisms inside macrophages, its usefulness has been re-appraised. In combination with other bactericidal drugs, it contributes to speed up the sterilization of tuberculous lesions. A review of the more recent clinical trials allows to assess the real toxicity of Pyrazinamide. Prescribed at a daily dosage of 30 to 35 mg/kg (1,5 to 2 g daily), it gives no major side effects.

Topics: Chemical and Drug Induced Liver Injury; Diarrhea; Drug Eruptions; Gout; Humans; Isoniazid; Nausea; Pyrazinamide; Rifampin; Streptomycin; Tuberculosis

Previous research in healthy volunteers has demonstrated that rifampicin and adjusted doses of lopinavir/ritonavir soft-gel capsules resulted in adequate exposure to lopinavir. Our objective was to study the combined use of rifampicin and the newly introduced lopinavir/ritonavir tablets.. A total of 40 healthy volunteers were planned to start with 600 mg rifampicin once daily from days 1-5. From days 6-15, volunteers were randomized to receive lopinavir/ritonavir tablets dosed as either 600/150 or 800/200 mg twice daily, both in addition to 600 mg rifampicin once daily. A 12 h pharmacokinetic curve was planned on day 15. Safety assessments were conducted regularly throughout the study period.. Eleven volunteers started as the first group in this study. No major complaints occurred during day 1-5 (rifampicin only). After addition of lopinavir/ritonavir, eight volunteers suffered from both nausea and vomiting, one from nausea only, and one from vomiting only. On day 7, increases in aspartate aminotransferase/alanine aminotransferase (AST/ALT) levels were reported in all volunteers and on day 8, the study was prematurely terminated. The AST/ALT levels continued to rise and peaked (grade 2, n = 2; grade 3, n = 1; grade 4, n = 8) on days 9-10. All values returned to normal within 6 weeks.. The study showed a high incidence of adverse events when a higher than standard dose of the new lopinavir/ritonavir tablets was combined with rifampicin. In the future, this drug combination should not be given to healthy volunteers. Liver function should be carefully monitored when rifampicin and lopinavir/ritonavir are combined in patients.

Topics: Adult; Alanine Transaminase; Antibiotics, Antitubercular; Aspartate Aminotransferases; Drug Administration Schedule; Drug Combinations; Drug Interactions; Female; HIV Protease Inhibitors; Humans; Lopinavir; Male; Middle Aged; Nausea; Pyrimidinones; Rifampin; Ritonavir; Tablets; Vomiting

The aim of this study was to assess the frequency of gastrointestinal side effects (GSE) and hepatotoxicity in patients treated with rifampicin for an osteoarticular infection and to determine if there is an association between rifampicin plasma concentrations and side effects. Rifampicin plasma concentrations were prospectively measured before (trough concentration, C(0)) and 2 +/- 0.5 h (peak concentration, C(2)) after drug intake. The presence of GSE, the alanine transferase (ALT) value, and concomitantly administered medications were recorded on the day rifampicin concentrations were measured. C(0) and C(2) were compared for differences regarding the presence or absence of side effects. Multivariate analysis was performed, with associated medications being taken into account. Seventy C(0) and 57 C(2) values were measured in 46 adults after a median treatment of 8 days (range, 1-179). Wide inter-individual variability was observed for C(0) and C(2). Thirteen (28%) patients reported GSE at least once. When GSE occurred, C(0) (median, 1 mg L(-1); range, 0.1-9.9 mg L(-1)) and C(2) (median, 10.3 mg L(-1); range, 1.8-40.3 mg L(-1)) were similar to C(0) (median, 0.6 mg L(-1); range, 0.1-10.3 mg L(-1)) and C(2) (median, 10.9 mg L(-1); range, 2.9-29.0 mg L(-1)) without GSE. The ALT value was more than normal in only three patients (6.5%) after rifampicin treatment began. The patients received no different associated medications whether or not GSE were present. Multivariate analysis showed no association between rifampicin plasma concentrations and GSE. GSE occur frequently in patients receiving rifampicin for osteoarticular infection but without an association with rifampicin plasma concentrations. Thus, therapeutic drug monitoring of rifampicin is irrelevant in the management of GSE.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury; Diarrhea; Digestive System; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Nausea; Osteomyelitis; Pilot Projects; Prospective Studies; Rifampin; Vomiting

The combination therapies recommended by the World Health Organization for treatment of brucellosis are doxycycline plus rifampicin or doxycycline plus streptomycin. Although highly successful results have been obtained with these two regimens, relapse rates as high as 14.4%. The most effective and the least toxic chemotherapy for human brucellosis is still undetermined. The aim of the present study was to investigate the efficacy, adverse effects and cost of ofloxacin plus rifampicin therapy, and doxycycline plus rifampicin therapy and evaluate in the treatment of brucellosis.. The open trial has been carried out prospectively by the two medical centers from December 1999 to December 2001 in Duzce region Turkey. The diagnosis was based on the presence of signs and symptoms compatible with brucellosis including a positive agglutination titre (>/=1/160) and/or a positive culture. Doxycycline and rifampicin group consisted of 14 patients who were given doxycycline 200 mg/day plus rifampicin 600 mg/day during 45 days and this group Ofloxacin plus rifampicin group was consisted of 15 patients who were given ofloxacin 400 mg/day plus rifampicin 600 mg/day during 30 days.. Regarding clinical and/or demographic characteristics no significant difference was found between two groups of patients that underwent two different therapeutic regimens. At the end of the therapy, two relapses were seen in both groups (p = 0.695). Although duration of therapy was two weeks shorter in group treated with rifampicin plus ofloxacin, the cure rate was similar in both groups of examinees. Fever dropped more rapidly in the group that treated with rifampicin plus ofloxacin, 74 +/- 30 (ranges 48-216) vs. 106 +/- 26 (ranges 48-262) hours (p = 0.016).. Ofloxacin plus rifampicin therapy has advantages of shorter treatment duration and provided shorter course of fever with treatment than in doxycycline plus rifampicin therapy. However, cost of ofloxacin plus rifampicin treatment is higher than doxycycline plus rifampicin treatment. Because of the similar effects, adverse effects and relapses rates between two regimens, we still advice doxycycline plus rifampicin for the treatment of brucellosis for countries, which have limited resources.

Topics: Adolescent; Adult; Brucellosis; Diarrhea; Doxycycline; Drug Costs; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Nausea; Ofloxacin; Rifampin; Time Factors; Treatment Outcome

The aim of our study was to evaluate and compare the therapeutic efficacy & safety profile of three different antituberculous regimens for pulmonary tuberculosis. The study sample size included 90 newly diagnosed, sputum positive patients of pulmonary. tuberculosis. 30 each from different groups. The parameters studied were, therapeutic efficacy included weight gain, cough, sputum examination and safety profile: nausea, vomiting, anorexia, gastritis, hepatitis, jaundice diarrhoea, rashes, dizziness, tingling & numbness, flu like symptoms & joint aches. Group-I showed statistically significant weight gain when compared to Group-II. Improvement in cough and conversion to smear negative were seen in 100% of patients in Group-I, 83.3% of patients in Group-II and 93.3% of patients in Group-III. Therapeutic efficacy was highest with Group I regimen, followed by Group III and Group II which was least efficacious. Group II also registered; the maximum cost and highest incidence of adverse effects.

Topics: Adult; Antitubercular Agents; Dizziness; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Gastritis; Humans; Hypesthesia; Isoniazid; Male; Nausea; Pyrazinamide; Rifampin; Streptomycin; Treatment Outcome; Tuberculosis, Pulmonary

The aim of this study was to determine the efficacy of novobiocin and rifampin as oral antibiotic prophylaxis for the prevention of catheter-related infection in melanoma patients treated with interleukin-2 (IL-2) plus interferon-alpha and chemotherapy (biochemotherapy).. Patients with advanced melanoma who were treated with biochemotherapy at the University of Texas M. D. Anderson Cancer Center were randomized in a crossover study to receive either oral antibiotic prophylaxis consisting of novobiocin and rifampin or observation alone over a 35-day course period. Patients were subsequently "crossed over" to the opposite arm of the study for an additional 35-day period, with each serving as his or her own control.. Twenty-six patients were enrolled. Nine patients (35%) failed to tolerate oral antibiotics because of severe nausea and vomiting; 17 patients (65%) were crossed over and considered evaluable. During the control patient courses, 71% of evaluable patients had infectious complications, 41% had a catheter-associated bacteremia, and 53% had a local catheter infection. In contrast, of the patients treated with antibiotic prophylaxis, only 12% had an infectious complication (P = 0.001), 12% had a local catheter infection (P = 0.008), and 6% had catheter-associated bacteremias (P = 0.04). Thirty-six episodes of catheter infections occurred during the 17 control courses, whereas only 3 episodes occurred during antibiotic prophylaxis (P < 0.001).. Although more than one-third of patients receiving IL-2 treatment with biochemotherapy failed to tolerate novobiocin and rifampin, this oral antibiotic regimen was efficacious in preventing the infectious complications, especially those associated with vascular catheters, in this high risk patient population.

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Bacteremia; Bacterial Infections; Catheterization, Central Venous; Catheterization, Peripheral; Catheters, Indwelling; Chemoprevention; Cross-Over Studies; Equipment Contamination; Female; Humans; Immunologic Factors; Interferon-gamma; Interleukin-2; Male; Melanoma; Middle Aged; Nausea; Novobiocin; Prospective Studies; Rifampin; Vomiting

There is growing concern, even among developed countries, about the increasing incidence of multidrug-resistant tuberculosis (MDR-TB). Results are reported from a study investigating ofloxacin used in the treatment of 57 patients with MDR-TB. Patients received ofloxacin 400 mg/day as well as three other sensitive anti-TB drugs based on susceptibility tests. Treatment duration was 9 months. Preliminary results of 35 evaluable patients show 55% of MDR-TB cases converted to smear and culture negative within 3 months of therapy. Ofloxacin in combination with other sensitive anti-TB medication shows promise in the treatment of MDR-TB and further studies are recommended.

Topics: Adult; Drug Resistance, Multiple; Drug Therapy, Combination; Female; Humans; Indonesia; Isoniazid; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium tuberculosis; Nausea; Ofloxacin; Prospective Studies; Pyrazinamide; Rifampin; Tuberculosis, Multidrug-Resistant

Topics: Adult; Alanine Transaminase; Antibodies; Ethambutol; Female; Fever; Humans; Jaundice; Male; Middle Aged; Nausea; Pain; Placebos; Pyrazinamide; Respiratory Tract Diseases; Rifampin; Skin Manifestations; Tuberculosis, Pulmonary

Linezolid (LZD), an antimicrobial agent against methicillin-resistant Staphylococcus aureus, demonstrates good bone and joint penetration, and is used for prosthetic bone and joint infections. Recently, we observed vomiting in several patients administered LZD. However, there are few reports on the incidence rate of, and risk factors for, LZD-induced nausea and vomiting. In this study, we aimed to verify the relationship between LZD administration and vomiting. Patients administered LZD at the Department of Orthopedic Surgery of Hokkaido University Hospital between November 2008 and December 2017 were enrolled in the study. The primary endpoint was the comparison of the vomiting rate between patients administered LZD (LZD group) and those administered other antibiotics (non-LZD group). For the secondary endpoint, to verify the risk factors of vomiting, a univariate logistic regression analysis was performed. In total, 130 patients were included in this study; 77 patients in the LZD group, and 53 in the non-LZD group. Vomiting occurred in 18 patients in the LZD group and 4 patients in the non-LZD group (23.4% and 7.5%, respectively); this was significantly higher in the LZD group. In the univariate logistic regression analysis, LZD administration, gender (female), age ≥65 years, renal impairment (creatinine clearance <60 mL/min) and concomitant use of rifampicin were extracted as potential risk factors of vomiting. The results of this study reveal a possible relationship between LZD administration and vomiting.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Drug Therapy, Combination; Female; Humans; Linezolid; Logistic Models; Male; Middle Aged; Nausea; Rifampin; Risk Factors; Vomiting; Young Adult

There are several reports to demonstrate that rifampicin, a major anti-tuberculosis agent, is associated with some adverse renal effects, with a few cases of rifampicin-induced minimal change disease (MCD). In the present case, a 68-year-old female presented with nausea, vomiting, foamy urine, general weakness and edema. She had been taking rifampicin for 4 weeks due to pleural tuberculosis. The patient had no proteinuria before the anti-tuberculosis agents were started, but urine tests upon admission showed heavy proteinuria with a 24-h urinary protein of 9.2 g/day, and serum creatinine, albumin, and total cholesterol levels were 1.36 mg/dL, 2.40 g/dL, and 283 mg/dL, respectively. MCD was diagnosed, and the patient achieved complete remission after cessation of rifampicin without undergoing steroid therapy.

Topics: Aged; Antibiotics, Antitubercular; Edema; Female; Humans; Kidney Function Tests; Kidney Glomerulus; Nausea; Nephrosis, Lipoid; Proteinuria; Remission Induction; Rifampin; Treatment Outcome; Tuberculosis, Pleural

Topics: Abdominal Pain; Adult; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Diagnosis, Differential; Doxycycline; Female; Fever; Humans; Nausea; Rifampin; Vomiting

p-Chloroaniline is more potent at producing methemoglobin than aniline in animal models. This case highlights the clinical presentation of an inhalation exposure to p-chloroaniline and associated laboratory analysis. An in-vitro study evaluating the metabolism of p-chloroaniline in human hepatocytes was undertaken to evaluate the metabolic fate more closely.. A 20 year-old man was working at a chemical waste plant when he developed dizziness, abdominal pain, and nausea. The exam was remarkable for coma, tachycardia, cyanosis, and pulse oximetry of 75%. Arterial blood gases showed a pH 7.38, pCO(2) 41 mmHg, pO(2) 497 mmHg, bicarbonate 24 mEq/L and methemoglobin 69%. Methylene blue administration led to complete recovery without sequelae. p-Chloroaniline was later identified as the chemical involved. He denied direct contact with the chemical, but was not wearing a dust mask or respirator. GC/MS confirmed p-chloroaniline and metabolites in the patient's urine.. Human hepatocytes were incubated with 100 microM p-chloroaniline for 24 hours, in both rifampicin- and vehicle only-treated cells. The cell culture medium was collected for GC/MS analysis for p-chloroaniline metabolites.. Similar to the patient sample, both p-chloroaniline and p-chloroacetanilide were identified by GC/MS in hepatocytes incubated with p-chloroaniline. Neither p-chloroaniline incubated in empty cell culture nor direct GC/MS injection of p-chloroaniline generated any p-chloroacetanilide via non-enzymatic degradation.. The seemingly innocuous dermal and inhalation exposure to p-chloroaniline dust can lead to life-threatening methemoglobinemia. The diagnosis can be confirmed with GC/MS analysis of the patient's urine, searching for p-chloroaniline and its primary metabolite p-chloroacetanilide.

Topics: Abdominal Pain; Acetanilides; Air Pollutants; Aniline Compounds; Antidotes; Bicarbonates; Cells, Cultured; Clinical Laboratory Techniques; Coma; Cyanosis; Dizziness; Gas Chromatography-Mass Spectrometry; Hepatocytes; Humans; Inhalation Exposure; Male; Methemoglobin; Methemoglobinemia; Methylene Blue; Nausea; Occupational Exposure; Oximetry; Rifampin; Tachycardia; Toxicology; Young Adult

The WHO MDT regimens have proved highly successful in preventing relapse of leprosy cases. It has indirectly lad to marked reduction in prevalence of disabilities. For PB leprosy, rifampicin 600 mg monthly and 100 mg dapsone daily for a total of 6 months therapy is required. For MB leprosy clofazimine 300 mg once monthly, supervised and 50 mg daily self administered is added. For single skin lesion the current WHO recommendation is 600 mg rifampicin + 400 mg ofloxacin + 100 mg minocycline given as a single dose for adults. Dose adjustment for children and clinical information have been discussed in a nutshell. A number of trials are going on, some are yet to be completed which do offer the prospect of perhaps simplifying therapy and improving with shorter duration.

Topics: Anti-Bacterial Agents; Clofazimine; Dapsone; Dose-Response Relationship, Drug; Drug Combinations; Drug Therapy; Drug-Related Side Effects and Adverse Reactions; HIV Infections; Humans; Hypersensitivity; India; Leprosy; Minocycline; Nausea; Ofloxacin; Rifampin; Secondary Prevention; Tuberculosis; World Health Organization

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

Possible toxic side-effects of antituberculous chemotherapy are studied in 718 children affected with pulmonary tuberculosis. 26 (3.62%) presented adverse side-effects and one drug had to be changed in 8 (1.11%). Treatment had to be stopped in one (0.13%) due to toxicity. Liver toxicity was specially studied, showing that younger age is a risk factor (p less than 1 X 10(-10). In 44 cases (16.54%) transient increases of no more than triple of maximum normal value, were found in SGOT and/or SGPT. Toxicity observed in controlled clinical studies and guides for treatment are exposed.

Topics: Adolescent; Antitubercular Agents; Blood Coagulation Disorders; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Drug Eruptions; Drug Therapy, Combination; Humans; Infant; Infant, Newborn; Isoniazid; Nausea; Nervous System Diseases; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Aged; Antibody Formation; Bilirubin; Biopsy; Diarrhea; Female; Humans; Kidney; Nausea; Rifampin; Urea

Topics: Antibody Formation; Antigen-Antibody Reactions; Drug Therapy, Combination; Fever; Headache; Humans; Isoniazid; Nausea; Purpura, Thrombocytopenic; Pyridoxine; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Topics: Ambulatory Care; Drug Therapy, Combination; Ethambutol; Female; Headache; Humans; Male; Nausea; Purpura, Thrombocytopenic; Rifampin; Tuberculosis, Pulmonary; Vomiting

Topics: Body Weight; Drug Therapy, Combination; Ethambutol; Female; Fever; Headache; Humans; Male; Nausea; Pain; Purpura, Thrombocytopenic; Rifampin; Time Factors; Tuberculosis, Pulmonary; Vomiting

Topics: Acute Kidney Injury; Antibodies; Drug Therapy, Combination; Ethambutol; Fever; Headache; Hemorrhage; Humans; Liver Function Tests; Nausea; Purpura, Thrombocytopenic; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Alanine Transaminase; Alkaline Phosphatase; Anorexia Nervosa; Bilirubin; Child; Humans; Isoniazid; Liver; Nausea; Rifampin; Vomiting

Topics: Adolescent; Adult; Aged; Bronchitis; Bronchopneumonia; Enterobacteriaceae; Feeding and Eating Disorders; Female; Haemophilus influenzae; Humans; Leukemia, Myeloid, Acute; Male; Middle Aged; Nausea; Neoplasm Metastasis; Pleural Neoplasms; Pleurisy; Pleuropneumonia; Pneumonia, Pneumococcal; Pulmonary Emphysema; Rifampin; Sputum; Staphylococcus