rifampin and Nutrition-Disorders

Antituberculosis drug-induced hepatotoxicity is quite common. However, factors predicting its development are still controversial. The objective of the present study was to evaluate the role of certain factors (age and sex of the patient, alcoholism, chronic liver disease, hepatitis B virus carrier status, acetylator status, nutritional status and antituberculosis treatment (ATT) regimen) in predicting the development of ATT-induced hepatitis. In a case-control study, 60 consecutive patients with evidence of ATT-induced hepatitis were studied to assess the possible association of the above-mentioned factors with ATT-induced hepatitis. Body mass index was found to be significantly lower in ATT-induced hepatitis patients (17.2 +/- 2.7) than in controls (19.5 +/- 3.3) (p < 0.05). Pyrazinamide was used in addition to isoniazid and rifampicin in a significantly higher percentage of patients in the ATT-induced hepatitis group (70%) as compared with those in the control group (42%). No significant differences were observed between the two groups with regard to the rest of the parameters.

Topics: Adolescent; Adult; Antitubercular Agents; Body Mass Index; Case-Control Studies; Chemical and Drug Induced Liver Injury; Female; Humans; Isoniazid; Male; Middle Aged; Nutrition Disorders; Pyrazinamide; Rifampin

Forty-seven Gabonese children with tuberculosis either limited to the lung or associated with other localizations were treated with isoniazid-rifampin (INH + RIF). They had liver tests done during the first 6 months of treatment. In 30 patients (63.8%) there was an increase in aminotransferase levels [over 100 UI/l in 14 (29.2%)]. The main factors increasing the risk of hepatic toxicity was a high dosage of INH and overall malnutrition. In fact, the weights of patients presenting with signs of hepatic toxicity were significantly lower than those in children who had no alterations of liver function. 68% of the severely malnourished (marasmus of kwashiorkor) presented with high ALAT or ASAT levels during treatment. The eventual role of the chronic HBV carrier state is discussed as 2 children presented with a chronic form of hepatitis at the time the treatment was initiated.

Topics: Adolescent; Africa; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Drug Combinations; Female; Hepatitis B; Humans; Infant; Isoniazid; Liver; Male; Nutrition Disorders; Rifampin; Transaminases; Tuberculosis, Pulmonary

A single dose kinetics of isoniazid and rifampicin alone, and combination was studied in well-nourished and malnourished patients of tuberculosis. The elimination half-life of isoniazid was significantly increased when administered in combination with rifampicin in well-nourished and malnourished patients, while no significant difference was observed in any of the pharmacokinetic parameters of rifampicin in combination with isoniazid or alone in both groups of patients. Results are discussed on the basis of pharmacokinetic drug interaction.

Topics: Acetylation; Adult; Female; Half-Life; Humans; Isoniazid; Male; Middle Aged; Nutrition Disorders; Phenotype; Rifampin; Spectrometry, Fluorescence; Tuberculosis

Topics: Administration, Oral; Biological Availability; Humans; Kinetics; Nutrition Disorders; Rifampin

Topics: Adolescent; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Drug Therapy, Combination; Humans; Infant; Isoniazid; Nutrition Disorders; Rifampin

Rifampicin 10 mg/kg was administered as a single dose to eight undernourished subjects, 10 well nourished subjects and 10 undernourished patients on continuous antituberculosis therapy as a single dose. The area under plasma time concentration (AUC0----infinity) and the peak concentration were significantly reduced in both the undernourished groups. The apparent oral and renal clearances were increased in both the undernourished groups. The (AUC0----infinity) was reduced in undernourished due to reduced absorption and/or changes in total body clearance or disposition. The plasma protein binding of the drug was significantly reduced in the undernourished resulting in increased free drug concentration. This might be sufficient to ensure adequate therapeutic efficacy. Therefore alteration in dosage regimes are not necessary in the undernourished.

Topics: Biological Assay; Blood Proteins; Hemoglobins; Humans; Kinetics; Nutrition Disorders; Protein Binding; Rifampin; Tuberculosis, Pulmonary