rifampin and Respiratory-Tract-Diseases

Tuberculosis (TB) remains a common cause of death globally. A regimen of 12 doses of isoniazid (INH) and rifapentine given once weekly (INH/RPT-3) has recently been recommended by the World Health Organization for the treatment of latent TB infection (LTBI). We aimed to determine whether the INH/RPT-3 regimen had similar or lesser rates of adverse events compared to other LTBI regimens, namely INH for 9 months, INH for 6 months, rifampin for 3 to 4 months, and rifampin plus INH for 3 to 4 months.. We searched MEDLINE, Embase, CENTRAL, PubMed, ICTRP, clinicaltrials.gov, and Canadian Agency for Drugs and Technologies in Health's Gray Matters Light for randomized, postmarketing, and comparative nonrandomized studies of patients with confirmed LTBI that reported the frequency of at least 1 adverse event of relevance for a regimen of interest. The search included studies published until March 2017. The frequencies of adverse events were extracted and are presented descriptively.. Data from 23 randomized and 55 nonrandomized studies were included. Although inconsistent event reporting and high heterogeneity limited comparisons, the adverse event profile of INH/RPT-3 appeared generally favorable. Flu-like reactions were reported with an increased frequency and hepatotoxicity with a lower frequency than standard treatment.. While INH/RPT-3 had an overall low frequency of adverse events compared to INH monotherapy, reporting of adverse events for many regimens was limited meaning results should be interpreted cautiously. Future studies of LTBI treatment would benefit from more complete collection and reporting of adverse events and more consistent definitions of hepatotoxicity.

Topics: Antitubercular Agents; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Humans; Incidence; Isoniazid; Latent Tuberculosis; Respiratory Tract Diseases; Rifampin

Topics: Adult; Aged; Amantadine; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Cephalosporins; Cyclophosphamide; Drug Combinations; Erythromycin; Ethambutol; Humans; Metronidazole; Pyrazinamide; Respiratory Tract Diseases; Respiratory Tract Infections; Rifampin; Trimethoprim; Tuberculosis, Pulmonary

Topics: Acute Disease; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Aerosols; Asthma; Bronchitis; Chromones; Chronic Disease; Ethambutol; Humans; Mycoplasma Infections; Respiratory Insufficiency; Respiratory Tract Diseases; Respiratory Tract Infections; Rifampin; Tuberculosis; Tuberculosis, Pulmonary; Virus Diseases

Weekly rifapentine plus isoniazid for 3 months (3HP) is as effective as daily isoniazid for 9 months (9H) for latent tuberculosis infection in high-risk persons, but there have been reports of possible flu-like syndrome.. We identified clinically significant systemic drug reactions (SDR) and evaluated risk factors in patients who did not complete treatment in the PREVENT Tuberculosis study.. Among 7552 persons who received ≥ 1 dose of study drug, 153 had a SDR: 138/3893 (3.5%) with 3HP vs 15/3659 (0.4%) with 9H (P < .001). In the 3HP arm, 87 (63%) had flu-like syndrome and 23 (17%) had cutaneous reactions; 13/3893 (0.3%) had severe reactions (6 were hypotensive) and 6 reported syncope. Symptoms occurred after a median of 3 doses, and 4 hours after the dose; median time to resolution was 24 hours. There were no deaths. In multivariate logistic regression analysis, factors independently associated with SDR included receipt of 3HP (adjusted odds ratio [aOR] 9.4; 95% confidence interval [CI], 5.5, 16.2), white non-Hispanic race/ethnicity (aOR 3.3; 95% CI, 2.3, 4.7), female sex (aOR 2.0; 95% CI, 1.4, 2.9), age ≥ 35 years (aOR 2.0; 95% CI, 1.4, 2.9), and lower body mass index (body mass index [BMI]; P = .009). In a separate multivariate analysis among persons who received 3HP, severe SDR were associated with white non-Hispanic race/ethnicity (aOR 5.4; 95% CI, 1.8, 16.3), and receipt of concomitant non-study medications (aOR 5.9; 95% CI, 1.3, 27.1).. SDR were more common with 3HP, and mostly flu-like. Persons of white race, female sex, older age, and lower BMI were at increased risk. Severe reactions were rare and associated with 3HP, concomitant medication, and white race. The underlying mechanism is unclear.. NCT00023452.

Topics: Adolescent; Adult; Antitubercular Agents; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Isoniazid; Latent Tuberculosis; Male; Middle Aged; Prospective Studies; Respiratory Tract Diseases; Rifampin

The data on the incidence of Chlamydia and Mycoplasma infections in children with inflammatory diseases of the respiration organs are presented. The peculiarities of the clinical manifestations and the attempts to carry out the clinical differential diagnostication are described. The chemotherapeutic efficacies of erythromycin, rifampicin and tetracycline in the treatment of pneumonia due to Chlamydia and Mycoplasma in children were studied. There was observed similarity in the clinical signs of the infections. The differential diagnostication without the data on the disease etiology was shown impossible. Marked chemotherapeutic efficacies of erythromycin and rifampicin in the treatment of chlamydiosis and mycoplasmosis in infants were stated. The tetracyclines were found to be efficient in the treatment of older children.

Topics: Age Distribution; Child, Preschool; Chlamydia Infections; Chlamydia trachomatis; Diagnosis, Differential; Erythromycin; Humans; Incidence; Infant; Infant, Newborn; Pneumonia, Mycoplasma; Respiratory Tract Diseases; Rifampin; Tetracyclines

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

A 47-year-old Turkish female patient was diagnosed with tuberculosis of the sacro-iliac joints and terminal ileum. She developed a severe adverse drug reaction while taking first-line tuberculosis therapy consisting of isoniazid, pyrazinamide and rifampicin as Rifater and ethambutol. Within 5 min of ingestion she developed pruritic rash, angioedema and breathing difficulties, resulting in an A&E admission. The tuberculosis therapy was discontinued. Intradermal and oral challenge tests for rifampicin were conducted but abandoned early on due to reactions which included audible wheeze, vomiting, throat pain and violent rigours. Clinical manifestations were swiftly treated with appropriate medications. This resulted in a change to the tuberculosis treatment regime, where streptomycin, isoniazid, ethambutol and pyrazinamide were given for 2 months and isoniazid and ethambutol for 12 months. Allergic reactions to rifampicin are rare and should be distinguished from flushing due to pyrazinamide. Prompt diagnosis and treatment by clinicians can be life saving.

Topics: Antibiotics, Antitubercular; Drug Eruptions; Female; Humans; Middle Aged; Respiratory Tract Diseases; Rifampin; Tuberculosis, Spinal; Withholding Treatment

Topics: Adult; Cross Reactions; Female; Humans; Respiratory Tract Diseases; Rifabutin; Rifampin; Thrombocytopenia

Ample clinical material obtained in Yakutia was used to study the efficiency of combined treatment in patients with disseminated pulmonary tuberculosis concurrent with gastrointestinal and respiratory diseases. At the same time it was justifiable to employ alternatives to deliver antituberculous agents to the lesion focus (rectal dropwise administration, phono- and photophoresis of isoniazid, endobronchial colloid diluted rifampicin, and activated silver water diluted antituberculous drugs) with additional biophysical exposure. This made this group of patients have much better antituberculous agent intolerance, which increased nonbacterial isolation rates and closed decay cavities as compared with conventional methods for administering antituberculous agents.

Topics: Animals; Antibiotics, Antitubercular; Antitubercular Agents; Gastrointestinal Diseases; Humans; Isoniazid; Phonophoresis; Rabbits; Respiratory Tract Diseases; Rifampin; Time Factors; Tuberculosis, Pulmonary

From 8 cases of immuno-allergic accidents attributed to Rifampicine, the authors review the literature on the subject. The "flue like" syndrome is the most frequent and characteristic of those accidents, worsened by haematological and renal involvements. These accidents probably belong to a pathology of immuno-complexes in relaiton with the production of anti-Rifampicine antibodies. Among the different means of in vitro diagnosis, the test with the anti-complement antiglobulin is the most reliable, though not always in good correlation with clinical signs. Though rare and most often benign, these accidents should lead to prudence in treating recurrent tuberculosis or reusing Rifampicine after a momentary interruption.

Topics: Aged; Antibodies; Drug Hypersensitivity; Female; Humans; Purpura, Thrombocytopenic; Respiratory Tract Diseases; Rifampin; Skin Diseases; Tuberculosis, Pulmonary

Topics: Adult; Aged; Biliary Tract Diseases; Female; Humans; Male; Middle Aged; Respiratory Tract Diseases; Rifampin

Topics: Adult; Aged; Hepatitis; Humans; Middle Aged; Pyelitis; Respiratory Tract Diseases; Rifampin

Topics: Child, Preschool; Enteritis; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Pediatrics; Respiratory Tract Diseases; Rifampin; Urinary Tract Infections

Topics: Humans; Kidney Diseases; Liver Diseases; Respiratory Tract Diseases; Rifampin