rifampin and Skin-Diseases

The authors show a literary review on Mycoplasma pneumonia which represents a fifth of human pneumonia. M. pneumoniae is the major cause of illness in school-age children (5-9 years) and young adults and the peak incidence of illness occurs in this age. The infection appears mainly as an interstitial pneumonitis and the onset of illness is gradual, influence-like with few clinical symptoms and typical roentgenographic and bronchoscopic findings. Cold hemagglutinins appear in approximately 50% of patients. A severe prognosis can be associated with extrarespiratory symptoms; Erythromycin (as others macrolides) is the drug of choice.

Topics: Age Factors; Brain Diseases; Child; Child, Preschool; Erythromycin; Heart Diseases; Humans; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Prognosis; Rifampin; Seasons; Skin Diseases

Topics: Acne Vulgaris; Adult; Amikacin; Antitubercular Agents; Drug Hypersensitivity; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Male; Middle Aged; Pellagra; Pigmentation Disorders; Prothionamide; Pyrazinamide; Rifampin; Skin Diseases; Streptomycin; Thioacetazone

Sarcoidosis is a chronic granulomatous disease for which there are limited therapeutic options. This is the first randomized, placebo-controlled study to demonstrate that antimycobacterial therapy reduces lesion diameter and disease severity among patients with chronic cutaneous sarcoidosis.. To evaluate the safety and efficacy of once-daily antimycobacterial therapy on the resolution of chronic cutaneous sarcoidosis lesions.. A randomized, placebo-controlled, single-masked trial on 30 patients with symptomatic chronic cutaneous sarcoidosis lesions deemed to require therapeutic intervention.. A tertiary referral dermatology center in Nashville, Tennessee.. Participants were randomized to receive either the oral concomitant levofloxacin, ethambutol, azithromycin, and rifampin (CLEAR) regimen or a comparative placebo regimen for 8 weeks with a 180-day follow-up.. Participants were monitored for absolute change in lesion diameter and decrease in granuloma burden, if present, on completion of therapy.. In the intention-to-treat analysis, the CLEAR-treated group had a mean (SD) decrease in lesion diameter of -8.4 (14.0) mm compared with an increase of 0.07 (3.2) mm in the placebo-treated group (P = .05). The CLEAR group had a significant reduction in granuloma burden and experienced a mean (SD) decline of -2.9 (2.5) mm in lesion severity compared with a decline of -0.6 (2.1) mm in the placebo group (P = .02).. Antimycobacterial therapy may result in significant reductions in chronic cutaneous sarcoidosis lesion diameter compared with placebo. These observed reductions, associated with a clinically significant improvement in symptoms, were present at the 180-day follow-up period. Transcriptome analysis of sarcoidosis CD4+ T cells revealed reversal of pathways associated with disease severity and enhanced T-cell function following T-cell receptor stimulation.. clinicaltrials.gov Identifier: NCT01074554.

Topics: Administration, Oral; Adult; Aged; Anti-Bacterial Agents; Azithromycin; CD4-Positive T-Lymphocytes; Chronic Disease; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Humans; Levofloxacin; Male; Middle Aged; Ofloxacin; Rifampin; Sarcoidosis; Severity of Illness Index; Single-Blind Method; Skin Diseases; Transcriptome; Treatment Outcome; Young Adult

Topics: Adolescent; Adult; Aged; Aminosalicylic Acids; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Hypersensitivity; Drug Resistance, Microbial; Ethambutol; Female; Humans; Isoniazid; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium tuberculosis; Radiography; Rifampin; Skin Diseases; Sputum; Streptomycin; Time Factors; Tuberculosis, Pulmonary; United Kingdom

The Staphylococcus aureus can switch to a transient genotype-invariant dormancy, known as a persister, to survive treatment with high doses of antibiotics. This transient persister is an important reason underlying its resistance. There is an urgent need to find new antibacterial agents capable of eradicating methicillin-resistant S. aureus (MRSA) persisters. In this study, 37 new derivatives of cajaninstilbene acid (CSA) were designed and synthesized, and their biological activity against MRSA persisters was evaluated. Most of the newly synthesized derivatives exhibit more potent antimicrobial properties against S. aureus and MRSA than CSA itself, and 23 of the 37 derivatives show a tendency to eradicate MRSA persisters. A representative compound (A6) was demonstrated to target bacterial cell membranes. It eradicated the adherent biofilm of MRSA in a concentration dependent manner, and showed a synergistic antibacterial effect with piperacilin. In a model mouse abscess caused by MRSA persisters, A6 effectively reduced the bacterial load in vivo. These results indicate that A6 is a potential candidate for treatment of MRSA persister infections.

Topics: Animals; Anti-Bacterial Agents; Biofilms; Cell Survival; Cell Wall; Disease Models, Animal; Methicillin-Resistant Staphylococcus aureus; Mice; Microbial Sensitivity Tests; RAW 264.7 Cells; Salicylates; Skin Diseases; Staphylococcal Infections; Staphylococcus aureus; Stilbenes; Structure-Activity Relationship

Up to 1.3 million children from the former Soviet Union (fSU) and Eastern Europe have been placed in institutional care worldwide. With the hope of ensuring the child's health in the immediate post-adoption period, these children are known to receive many injections of vaccines, vitamins, and medications, many unnecessary and often administered with unsafe technique. This practice can lead to formation of suppurative granulomas in these children. Though rare, dermatologists should be aware of these conditions in adoptees from Eastern Europe.

Topics: Abscess; Child, Adopted; Clarithromycin; Europe, Eastern; Female; Granuloma; Humans; Infant; Injections, Intramuscular; Rifampin; Risk Assessment; Russia; Skin Diseases; USSR

There are limited data on the epidemiology, diagnosis and optimal management of nontuberculous mycobacterial (NTM) disease in children.. Retrospective cohort study of NTM cases over a 10-year-period at a tertiary referral hospital in Australia.. A total of 140 children with NTM disease, including 107 with lymphadenitis and 25 with skin and soft tissue infections (SSTIs), were identified. The estimated incidence of NTM disease was 0.6-1.6 cases / 100,000 children / year; no increasing trend was observed over the study period. Temporal analyses revealed a seasonal incidence cycle around 12 months, with peaks in late winter/spring and troughs in autumn. Mycobacterium-avium-complex accounted for most cases (77.8%), followed by Mycobacterium ulcerans (14.4%) and Mycobacterium marinum (3.3%). Polymerase chain reaction testing had higher sensitivity than culture and microscopy for acid-fast bacilli (92.0%, 67.2% and 35.7%, respectively). The majority of lymphadenitis cases underwent surgical excision (97.2%); multiple recurrences in this group were less common in cases treated with clarithromycin and rifampicin compared with clarithromycin alone or no anti-mycobacterial drugs (0% versus 7.1%; OR:0.73). SSTI recurrences were also less common in cases treated with two anti-mycobacterial drugs compared with one or none (10.5% versus 33.3%; OR:0.23).. There was seasonal variation in the incidence of NTM disease, analogous to recently published observations in tuberculosis, which have been linked to seasonal variation in vitamin D. Our finding that anti-mycobacterial combination therapy was associated with a reduced risk of recurrences in patients with NTM lymphadenitis or SSTI requires further confirmation in prospective trials.

Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Clarithromycin; Cohort Studies; DNA, Bacterial; Female; Humans; Infant; Infant, Newborn; Lymphadenitis; Male; Mycobacterium avium Complex; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Mycobacterium ulcerans; Retrospective Studies; Rifampin; Skin Diseases; Soft Tissue Infections; Tertiary Care Centers

Cutaneous vasculitis is a clinical entity with a broad differential diagnosis, including an adverse drug reaction. It is defined as inflammation of skin blood vessel walls. During a 7-year-period, we observed three patients who developed isolated cutaneous vasculitis during antibiotic therapy of bacterial infection. All were treated with a fluoroquinolone (ciprofloxacin or levofloxacin) combined with rifampin (two cases) or flucloxacillin (three cases), respectively. In all three cases the lesions gradually resolved after treatment with the inciting fluoroquinolone had been stopped. In one patient, leukocytoclastic small-vessel vasculitis was histologically confirmed. Fluoroquinolone-associated cutaneous vasculitis consists of an isolated self-limiting disorder that is part of a systemic vasculitis, or even life-threatening disease. Clinicians should be aware of this serious adverse event because any continuation of treatment may be fatal.

Topics: Aged; Anti-Bacterial Agents; Bacterial Infections; Drug Therapy, Combination; Floxacillin; Fluoroquinolones; Humans; Male; Rifampin; Skin Diseases; Vasculitis; Withholding Treatment

Topics: Adult; Animals; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Doxycycline; Humans; Male; Rifampin; Skin Diseases

Topics: Diagnosis, Differential; Drug Therapy, Combination; Granuloma; Humans; Leprostatic Agents; Leprosy; Male; Middle Aged; Ofloxacin; Rifampin; Skin Diseases

Topics: Adult; Clofazimine; Dapsone; Diagnosis, Differential; Drug Therapy, Combination; Face; Humans; Leprostatic Agents; Leprosy; Male; Rifampin; Skin Diseases; Thalidomide

Acquired perforating dermatosis (APD) is a very rare disorder which has been described in association with systemic diseases such as diabetes mellitus, HIV infection or lymphoma. In this report we describe a patient with APD associated with sclerosing cholangitis and diabetes mellitus who was successfully treated with rifampicin. A 33-year-old Indian woman with a history of extensive pancreatic surgery, sclerosing cholangitis and insulin dependent diabetes mellitus was referred to our unit with intractable pruritus. She was treated with cholestyramine, ursodeoxycholic acid, several analgesics, UVB therapy, topical steroids, sedative antihistamines and plasmapheresis without significant improvement. Increasingly severe itching was associated with papular skin changes limited initially to the lower limbs but which later involved her entire body. Biopsy of a representative lesion showed the changes of APD. She was subsequently treated with rifampicin which produced a dramatic resolution of pruritus within 3 weeks and the skin changes progressively resolved over subsequent months. In this newly described association of APD with sclerosing cholangitis, rifampicin treatment appeared to be efficient in ameliorating pruritus and the papular skin changes typical of APD.

Topics: Adult; Antibiotics, Antitubercular; Cholangitis, Sclerosing; Female; Humans; Rifampin; Skin Diseases; Treatment Outcome

In order to determine the efficacy of short course chemotherapy (SCC) for tuberculosis in children, 83 newly diagnosed cases in children < 12 years old were given SCC and were prospectively followed for 1-3 years. Seventy-one cases were treated for 6-9 months as they had mild to moderate involvement. Twelve cases were treated for 12 months as they had meningitis (7), disseminated tuberculosis (2), or miliary tuberculosis (3). The results showed that none of the children, at the end of follow up, showed evidence of active tuberculosis. All children tolerated the drugs well, with side effects noticed being mild, namely transient hepatitis (4), vomiting (1), and skin rash (1). It is suggested that SCC for 6-9 months using isoniazid (INH) and rifampicin along with other drugs when necessary is highly effective in most cases of tuberculosis in children and has several advantages over conventional chemotherapy of 18 months or longer duration.

Topics: Adolescent; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Infant; Infant, Newborn; Isoniazid; Male; Pyrazinamide; Rifampin; Skin Diseases; Streptomycin; Tuberculosis; Vomiting

Topics: Child, Preschool; Clofazimine; Consanguinity; Drug Therapy, Combination; Ethambutol; Female; Hepatomegaly; Humans; Immunity, Cellular; Joint Diseases; Mycobacterium Infections; Rifampin; Skin Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

A cluster of toxic reactions among children inadvertently given excessive doses of rifampin for chemoprophylaxis of invasive Haemophilus influenzae disease in a day-care center was investigated. In all 19 children, who received five times the therapeutic dose of rifampin, dramatic adverse reactions developed. A striking, "glowing" red discoloration of the skin and facial or periorbital edema were found to be the hallmarks of rifampin toxicity. These clinical signs of acute toxicity contrast sharply with the adverse side effects of rifampin reported with therapeutic doses.

Topics: Acute Disease; Child Day Care Centers; Child, Preschool; Edema; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Medication Errors; Pigmentation Disorders; Rifampin; Scalp Dermatoses; Skin Diseases; Vomiting

Topics: Cyclosporins; Drug Interactions; Drug Therapy, Combination; Female; Humans; Middle Aged; Rifampin; Skin Diseases; Staphylococcal Infections

With reference to an observation of porphyria variegata, which was complex and unusual as all such observations are, the direct responsibility of rifampicin is underscored. Porphyria variegata should be considered in two situations. The first of these is a dramatic acute neuroabdominal picture: the diagnosis of acute hepatic porphyria is established by the measurement of urinary porphyrins; the second step is to distinguish between the three acute hepatic porphyrias by looking for cutaneous manifestations and determining the respective proportions of coproporphyrins and protoporphyrins in the stools. In porphyria variegata, fecal protoporphyrins are significantly increased. The second situation is cutaneous involvement suggestive of late-onset cutaneous porphyria: porphyria variegata as well as hereditary coproporphyria in the cutaneous phase must be considered. Diagnosis can be established only through measuring fecal porphyrins. Porphyria variegata is a genetic enzymatic disorder inherited on an autosomal dominant basis. A study of the family is required in all cases, but the conventional methods for detecting heterozygotes for porphyria variegata are not satisfactory. Carriers will be unequivocally distinguished from healthy subjects only through measuring the defective enzyme activity.

Topics: Acute Disease; Adult; Chemical and Drug Induced Liver Injury; Feces; Humans; Liver Diseases; Male; Polyradiculoneuropathy; Porphyrias; Porphyrins; Rifampin; Skin Diseases

Between January 1976 and June 1981, 814 patients with pulmonary tuberculosis were treated for 9 months with isoniazid (INH) and rifampin (RIF), daily for 1 month and twice weekly for the other 8 months. Overall success was achieved in 95% of the 586 patients who completed therapy: in 15 patients (2.9%), sputum cultures failed to convert to negative during therapy, and 10 patients (1.7%) have relapsed since stopping the chemotherapy. Major toxic effects occurred in 22 patients; in 14 during the daily phase and in 8 during the twice-weekly phase. Hepatic toxicity occurred in 13 patients during daily and in 5 during twice-weekly treatment, and it was caused by RIF in 5, INH in 10, and was undetermined in 3. Hematologic abnormalities developed in 4 patients: in 1 during the daily and in 3 during the twice-weekly phase. Minor side effects, which were not life threatening, were encountered in 62 patients: in 35 during the daily and in 27 during the twice-weekly therapy. These were gastrointestinal intolerance in 18, drug fever in 27 (including 11 with "flu-syndrome" during twice-weekly administration), cutaneous rashes in 14, and headache, general malaise, and weakness in 3. These side effects were produced by RIF in 43, by INH in 18, and the responsible drug was not identified in 1. Hypersensitivity reactions to twice-weekly administration of RIF were infrequent. Clinical surveillance for toxicity is preferred over routine and regular biochemical monitoring.

Topics: Adolescent; Adult; Aged; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Female; Fever; Gastrointestinal Diseases; Hematologic Diseases; Humans; Isoniazid; Male; Middle Aged; Rifampin; Skin Diseases; Tuberculosis, Pulmonary

Topics: Humans; Minocycline; Mycobacterium; Mycobacterium Infections; Nontuberculous Mycobacteria; Rifampin; Skin Diseases; Tuberculin Test

Topics: Adult; Humans; Male; Porphyrias; Rifampin; Skin Diseases

A patient who developed porphyria cutanea tarda and disturbed liver function tests following treatment with rifampicin and isoniazid for a tuberculous psoas abscess is reported. The patient had normal liver function tests prior to receiving anti-tuberculosis chemotherapy, but was subsequently demonstrated to have cholelithiasis. Challenge testing with both drugs incriminated rifampicin as the agent precipitating porphyria cutanea tarda and disturbance of the liver function tests particularly the serum bilirubin. The association between rifampicin and porphyria cutanea tarda has not previously been described but might be expected because of the ability of rifampicin to induce various liver enzyme systems including delta aminolevulinic acid synthetase activity. This further illustration of rifampicin hepatotoxicity emphasizes the need for regular monitoring of liver function when rifampicin is prescribed. Rifampicin should be used with extreme caution in any patient with a previous history of porphyria cutanea tarda.

Topics: Drug Eruptions; Humans; Liver Function Tests; Male; Middle Aged; Porphyrias; Rifampin; Skin Diseases

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: Cryoglobulins; Erythema; Humans; Hypersensitivity; Purpura; Rifampin; Skin; Skin Diseases; Syndrome; Vascular Diseases

Topics: Abscess; Bronchopneumonia; Empyema; Enteritis; Humans; Pharyngitis; Pneumonia; Respiratory Tract Infections; Rhinitis; Rifampin; Skin Diseases

Topics: Adolescent; Adult; Aged; Child; Female; Gonorrhea; Humans; Male; Middle Aged; Rifampin; Skin Diseases

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Lupus Vulgaris; Male; Middle Aged; Rifampin; Sexually Transmitted Diseases; Skin Diseases; Tuberculosis

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Dermatitis, Contact; Eczema; Female; Furunculosis; Humans; Infant; Lupus Vulgaris; Male; Middle Aged; Pyoderma; Rifampin; Skin Diseases; Syphilis, Cutaneous; Tuberculosis, Cutaneous

Topics: Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Piperazines; Rifampin; Skin Diseases

Topics: Adolescent; Adult; Bone Diseases; Central Nervous System Diseases; Female; Humans; Injections, Spinal; Male; Middle Aged; Neurosurgery; Pneumococcal Infections; Rifampin; Skin Diseases; Staphylococcal Infections