rifampin and Pain

Intra-articular hemorrhage is the clinical hallmark of hemophilia. Synoviorthesis, the intra-articular injection of chemical or radioactive substances in order to produce fibrosis of the hypertrophied synovium, has proved effective in the treatment of chronic hemophilic synovitis. Between December 2006 and July 2007, we treated 21 patients with hemophilic arthropathy by synoviorthesis with rifampicin once a week. The procedures were performed on 14 knees, five elbows, four ankles, and one shoulder (24 joints and 113 injections). The mean age was 16.7 years (range, 7-49 years). According to the Fernandez-Palazzi classification, synoviorthesis was considered satisfactory (excellent or good) in 21 (87.5%) joints and unsatisfactory (fair or poor) in three (12.5%). A mean reduction of 6.3 bleeding episodes per month was obtained (P < 0.0001). The mean pain score was reduced from 2.62 (range, 2-3; SD, 0.49) before treatment to 0.79 (range, 0-2; SD, 0.65) after treatment. The mean World Federation of Hemophilia (WFH) score was 5.45 (range, 2-8) before synoviorthesis and 3.5 (range, 1-7) after treatment. This method effectively reduced hemarthrosis and pain and also improved the range of motion in patients with hemophilic arthropathy. Chemical synoviorthesis with rifampicin appears to be efficient, inexpensive, and simple and also especially practical in developing countries where radioactive agents are not easily available.

Topics: Adolescent; Adult; Child; Hemarthrosis; Hemorrhage; Humans; Joint Diseases; Middle Aged; Pain; Range of Motion, Articular; Rifampin; Synovial Membrane; Treatment Outcome; Young Adult

Does the addition of 600 mg rifampicin or 50 mg methotrexate improve pain relief after injection of the rheumatoid knee with 20 mg triamcinolone hexacetonide (TH)?. Eighty-two patients on stable therapy were allocated at random to receive intra-articular TH alone, TH and methotrexate (TH+M) or TH and rifampicin (TH+R). Pain was recorded by a weekly chart and analysed using the area under the curve (AUC), periods of total pain relief and duration of effect. Examinations and microwave thermography were performed by an independent meteorologist at baseline, 3 and 6 months.. Using the AUC, pain was significantly better in the TH+R group compared with TH alone (P=0.039, Mann Whitney U). The median duration of improved pain scores was 13.5 weeks with TH alone, 10 with TH+M and 19 with TH+R. Examination and microwave thermography revealed improvements compared with baseline, but there were no significant differences between the groups. Eleven of 28 patients treated with TH + R developed a flare of post-injection pain.. Whilst the addition of rifampicin improved pain relief, the occurrence of pain after injection remains a problem. Measures to minimize this are needed when TH+R is used.

Topics: Aged; Anti-Inflammatory Agents; Antirheumatic Agents; Arthritis, Rheumatoid; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Injections, Intra-Articular; Knee Joint; Male; Methotrexate; Middle Aged; Pain; Rifampin; Severity of Illness Index; Treatment Outcome; Triamcinolone Acetonide

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

Topics: Administration, Oral; Adolescent; Adult; Alanine Transaminase; Alkaline Phosphatase; Aspartate Aminotransferases; Bilirubin; Clinical Trials as Topic; Ethambutol; Female; Hospitalization; Humans; Isoniazid; Leukocyte Count; Liver Function Tests; Male; Middle Aged; Mycobacterium tuberculosis; Pain; Rifampin; Streptomycin; Tuberculosis, Pulmonary; United States; United States Public Health Service; Vertigo

Antibiotics are recognized as first-line treatments for hidradenitis suppurativa (HS), but the data on their efficacy are limited.. Evaluate the efficacy of oral clindamycin versus that of clindamycin plus rifampicin in patients with HS.. A total of 60 patients with mild-to-moderate-severe HS who were classified according to their International Hidradenitis Suppurativa Severity Score System (IHS4) and Hurley scores, were subdivided into 2 groups of 30 patients each (group A, the members of which received clindamycin plus rifampicin, and group B, the members of which were treated with clindamycin alone) and retrospectively studied. The main objective was to evaluate and compare the clinical and ultrasound responses between the groups after 8 weeks of treatment according to the Hidradenitis Suppurativa Clinical Response measure.. After the treatment, 17 of 30 patients in group A and 19 of 30 in group B met the primary outcome. Both groups showed a similar improvement of IHS4 score, whereas the Dermatology Life Quality Index and pain Visual Analogue Scale scores improved more in group B. In particular, the reductions in nodule and abscess counts were similar between the 2 groups, whereas the number of draining tunnels decreased more in group B. The factors significantly associated with Hidradenitis Suppurativa Clinical Response score were age, body mass index, IHS4 score, and absence of axillary involvement. Disease-free survival was similar between the 2 groups.. The study was not randomized or placebo-controlled.. Clindamycin may be a useful treatment alternative to antibiotic combination regardless of HS clinical stage.

Topics: Adolescent; Adult; Age Factors; Anti-Bacterial Agents; Body Mass Index; Clindamycin; Disease-Free Survival; Drug Therapy, Combination; Female; Hidradenitis Suppurativa; Humans; Male; Middle Aged; Pain; Quality of Life; Retrospective Studies; Rifampin; Severity of Illness Index; Treatment Outcome; Ultrasonography; Young Adult

Tuberculosis (TB) continues to be a prevalent disease worldwide; an estimated one third of the world's population is infected and 2015 data from the World Health Organization show 10 million people had an active infection. Although TB often is cited as a disease that most commonly occurs in underdeveloped countries, the evolution of drug-resistant forms of TB and infection sensitivity of immunocompromised individuals have made this disease a focal point for indus- trialized countries as well. When TB is spread, it commonly affects the lungs, but it can infect any organ of the body. An uncommon version - cutaneous TB - affects < 2% of all individuals with an active form of TB. This study describes a 34-year-old man with multiple comorbidities, including peripheral vascular disease and a remote history of travel to Latin America who presented to a wound care clinic with a 2-year history of painful shallow necrotic ulcers on his right lower limb and previous treatments that included a positive response to antibiotics. Once TB was con rmed via 2 posi- tive Quantiferon Gold tests, the patient received therapy (directly observed by the state health department) that included pyrazinamide, rifampin, ethambutol, isoniazid, and undocumented vitamin B6. Treatment for the TB-related lesions, con- comitant cellulitis, and a Stage 2 pressure injury under his rst right metatarsal head was initiated as well. The patient received local wound care for 40 days that included sharp debridement, of oading for the pressure injury, and pain relief before treatment at the wound care clinic and daily as prescribed by his primary care provider. All wounds were securely covered with collagen dressings followed by silicone-bordered bandages. Local wound care was provided for 40 days, with biweekly follow-up for an additional 30 days. The wounds resolved and the patient was discharged from the wound care clinic but remained on the caseload for 30 days in the event his pain increased or the wounds recurred. Cutaneous TB, uncommon and challenging, should be a consideration in patients with an increased likelihood of occurrence.

Topics: Adult; Anti-Bacterial Agents; Humans; Male; Pain; Peripheral Arterial Disease; Rifampin; Tuberculosis, Cutaneous; Ulcer; Wound Healing

Topics: Anti-Bacterial Agents; Asian People; Buruli Ulcer; Clarithromycin; Drug Therapy, Combination; Face; Female; Humans; Middle Aged; Mycobacterium ulcerans; Ofloxacin; Pain; Rifampin

The authors report a rare case of piriformis pyomyositis, in a teenage rugby player, who was initially feverish and presented to us with low back pain, sciatica and inability to mobilise due to pain. Subsequent imaging investigations (MRI scan) revealed abscess formation in the piriformis muscle with compression effect on the ipsilateral sciatic nerve. A course of intravenous antibiotic therapy followed by oral antibiotics fully resolved his symptoms and returned inflammatory markers back to normal.

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Floxacillin; Football; Humans; Low Back Pain; Magnetic Resonance Imaging; Male; Meropenem; Pain; Piriformis Muscle Syndrome; Pyomyositis; Rifampin; Sciatica; Staphylococcal Infections; Staphylococcus aureus; Thienamycins; Vancomycin

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Buruli Ulcer; Clarithromycin; Drug Therapy, Combination; France; Humans; Leg Ulcer; Male; Mali; Mycobacterium ulcerans; Pain; Rifampin; Travel; Treatment Outcome

Topics: Drug Interactions; Humans; Methadone; Pain; Rifampin

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Brucellosis; Cefuroxime; Child; Doxycycline; Female; Gentamicins; Humans; Immunoglobulin G; Joint Diseases; Kidney Diseases; Lyme Disease; Male; Methicillin-Resistant Staphylococcus aureus; Pain; Rifampin

Topics: Administration, Cutaneous; Analgesics, Opioid; Antibiotics, Antitubercular; Drug Interactions; Fentanyl; Humans; Male; Middle Aged; Pain; Rifampin; Treatment Failure

Continuous i.v. infusion of propofol, or propofol plus ketamine for deep sedation and analgesia was carried out in two patients with severe epidermolysis bullosa (EB) during extensive dressing changes and deep whirlpool baths. Intermittent small doses of narcotics were given as supplement for pain relief as needed. Both patients had typical features of severe EB, including extremity contractures, severe digit deformity, difficult airways, extensive blisters and broken skin with denuded areas and severe wound infections. SpO(2) was roughly estimated by holding the probe around the earlobe periodically and no other monitors could be applied because of the skin conditions and the settings of the procedures. Retrospective anesthesia record review showed that the combined propofol and ketamine infusions provided satisfactory sedation with significantly reduced narcotic requirements compared with propofol alone. There were no noticeable side effects when ketamine was added. Ketamine appears to be a good addition to propofol and narcotics to provide sedation and analgesia when there are great concerns for respiration depression, apnea, difficult pain management and potential unstable hemodynamics during dressing changes and whirlpool baths in severe EB patients.

Topics: Adolescent; Analgesics; Anesthetics, Intravenous; Anti-Bacterial Agents; Antibiotics, Antitubercular; Bandages; Drug Therapy, Combination; Epidermolysis Bullosa; Female; Humans; Hydrotherapy; Infusions, Intravenous; Ketamine; Male; Pain; Propofol; Rifampin; Severity of Illness Index; Vancomycin; Wound Infection

Topics: Adult; Antitubercular Agents; Bone and Bones; Combined Modality Therapy; Drug Therapy, Combination; Ethambutol; Fever; Humans; Isoniazid; Knee; Male; Pain; Pyrazinamide; Radiography; Radius; Rifampin; Treatment Outcome; Tuberculosis, Osteoarticular; Weight Loss; Wrist

Topics: Adenocarcinoma; Administration, Cutaneous; Aged; Analgesics, Opioid; Antibiotics, Antitubercular; Drug Interactions; Fentanyl; Humans; Lung Neoplasms; Male; Pain; Parotid Neoplasms; Rifampin; Tuberculosis, Pulmonary

Pruritus is prevalent in 5-12% of palliative care patients. Rifampicin has been shown to be useful both as initial treatment and as salvage treatment after failure of other agents to control the pruritus associated with the cholestatic jaundice of malignancy. We report the case of a 65-year-old woman who complained of severe pruritus after morphine treatment. The use of rifampicin 300 mg twice a day by the i.v. route was successful, and after opioid switching it was no longer necessary to maintain rifampicin in the therapeutic regimen. Controlled clinical trials are warranted to confirm this preliminary observation.

Topics: Aged; Analgesics, Opioid; Enzyme Inhibitors; Female; Humans; Morphine; Pain; Pruritus; Rifampin; Treatment Outcome

In an open study, a new treatment modality was evaluated in 22 patients with active ankylosing spondylitis and compared with oral treatment. Patients were given a 10-week course of rifamycin SV infiltrations to all large peripheral joints, whether or not affected, and were followed for up to 12 months after the end of treatment. Clinical improvements observed at the end of the 10-week treatment cycle persisted for 12 months: morning stiffness (P less than 0.02); subjective pain (P less than 0.0001); Schober's test (P less than 0.006); hand-ground distance (P less than 0.001); erythrocyte sedimentation rate (P less than 0.001); and C-reactive protein (P less than 0.04). The number of painful joints became significantly lower at 6 (P less than 0.01) and 12 months (P less than 0.02) of the follow-up period. Oral administration of rifampin at three times the intra-articular dosage was devoid of any therapeutic activity. It is not known how treatment of peripheral joints influenced the inflammatory process at the level of the axial skeleton. These results must be considered preliminary due to the small number of patients and the short follow-up period, and because it was an open study.

Topics: Administration, Oral; Adult; Female; Humans; Inflammation; Injections, Intra-Articular; Male; Pain; Rifampin; Rifamycins; Spondylitis, Ankylosing

Topics: Drug Therapy, Combination; Humans; Joint Diseases; Pain; Pyrazinamide; Rifampin; Tuberculosis, Pulmonary; Uric Acid

Topics: Anemia, Hemolytic; Coombs Test; Fever; Humans; Jaundice; Pain; Rifampin; Thrombocytopenia

Topics: Acute Kidney Injury; Aminosalicylic Acids; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Female; Humans; Middle Aged; Pain; Rifampin; Shock, Septic; Time Factors; Tuberculosis, Pulmonary

Topics: Aminosalicylic Acids; Biopsy, Needle; Chemical and Drug Induced Liver Injury; Child; Drug Eruptions; Ethambutol; Fever; Humans; Isoniazid; Liver; Male; Pain; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Topics: Adult; Body Weight; Drug Therapy, Combination; Ethambutol; Exanthema; Female; Fever; Follow-Up Studies; Gastrointestinal Diseases; Hemorrhage; Humans; Male; Middle Aged; Pain; Pyrazinamide; Recurrence; Rifampin; Shock; Sputum; Time Factors; Tuberculosis, Pulmonary

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

Topics: Chronic Disease; Coma; Dactinomycin; Daunorubicin; Dexamethasone; Encephalomyelitis; Fever; Headache; Humans; Idoxuridine; Leukopenia; Meningitis, Viral; Mental Disorders; Pain; Paralysis; Respiratory Insufficiency; Rifampin; Vomiting