rifampin and Vomiting

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

Acalculous cholecystitis etiologies while numerous, some of them are less-known such as brucellosis. In this report, we elaborate the clinical findings, investigations and management of two female patients presenting acalculous cholecystitis in whom diagnosis of acute brucellosis was retained. Both patients had fever, asthenia and abdominal tenderness. Laboratory results showed evidence of inflammation as well as hepatic cytolysis while cholestasis was noted in one patient. In both cases, ultrasound study and CT confirmed the presence of acalculous cholecystitis. Serology (tube agglutination test) led to the diagnosis of brucellosis. Diagnosis of brucellosis-related acute cholecystitis was established in both cases based on imaging findings as well as serology without resorting to cholecystectomy. Favourable clinical response to specific antibiotic therapy further supported our diagnosis as well as our decision to avoid surgery. Although few cases have been reported, brucellosis must be considered as a cause of acalculous cholecystitis, especially in endemic countries.

Topics: Abdominal Pain; Acalculous Cholecystitis; Acute Disease; Animals; Anti-Bacterial Agents; Brucellosis; C-Reactive Protein; Doxycycline; Female; Food Contamination; Humans; Middle Aged; Milk; Raw Foods; Rifampin; Treatment Outcome; Ultrasonography; Vomiting; Young Adult

Daily rifampin therapy is associated with minimal adverse effects, but administration on an intermittent or interrupted basis has been associated with severe immunoallergic reactions such as hemolytic anemia, acute renal failure, and disseminated intravascular coagulation. We describe a patient with Mycobacterium leprae infection who experienced recurrent episodes of disseminated intravascular coagulation after intermittent exposures to rifampin, and review eight previously reported cases of rifampin-associated disseminated intravascular coagulation. In six (75%) cases, previous exposure to rifampin was reported and seven (87.5%) patients were receiving the medication on an intermittent or interrupted basis. Clinical features of rifampin-associated disseminated intravascular coagulation included fever, hypotension, abdominal pain, and vomiting within hours of ingestion. Average time to reaction was 3-6 doses if rifampin was being administered on a monthly schedule. Three (37.5%) of eight reported cases were fatal. A complete history of previous exposure to rifampin is recommended before intermittent therapy with this medication.

Topics: Abdominal Pain; Aged; Anemia, Hemolytic; Disseminated Intravascular Coagulation; Dose-Response Relationship, Drug; Female; Fever; Humans; Hypotension; Leprosy; Rifampin; Vomiting

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 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

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

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

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

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: Administration, Oral; Ciprofloxacin; Humans; Infant; Male; Meningococcal Infections; Penicillins; Rifampin; Vomiting

To determine the efficacy of combination drug therapy for disseminated Mycobacterium avium complex infection in patients with the acquired immunodeficiency syndrome (AIDS).. Prospective, nonrandomized, before-after comparison.. Outpatient clinics at three university medical centers.. Seventeen patients with at least two consecutive blood cultures positive for M. avium complex who had not been previously treated with antituberculous medications. Fifteen of the seventeen patients completed at least 4 weeks of treatment.. Patients received daily intravenous amikacin (7.5 mg/kg body weight) for the first 4 weeks plus the following oral medications for at least 12 weeks: ciprofloxacin, 750 mg twice daily; ethambutol, 1000 mg daily; and rifampin, 600 mg daily.. The baseline geometric mean colony count from blood cultures decreased from 537/mL to 14/mL (P less than 0.001) after 4 weeks of therapy. The microbiologic suppression was sustained while on treatment and was associated with a decrease in systemic symptoms related to M. avium complex infection. Premature withdrawal from treatment (less than 12 weeks) occurred in 7 of 17 patients. The commonest reasons for early withdrawal were gastrointestinal intolerance and hepatic toxicity.. Mycobacterial load and systemic symptoms in patients with AIDS and disseminated M. avium complex infection can be effectively reduced by a regimen containing amikacin, ethambutol, rifampin, and ciprofloxacin.

Topics: Acquired Immunodeficiency Syndrome; Administration, Oral; Amikacin; Chemical and Drug Induced Liver Injury; Ciprofloxacin; Drug Therapy, Combination; Ethambutol; Female; Humans; Infusions, Intravenous; Male; Mycobacterium avium-intracellulare Infection; Rifampin; Vomiting

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

Although short-course, largely twice weekly chemotherapy for treatment of tuberculosis has been shown to be effective in other countries, when given under closely controlled conditions, it has not been adopted in this country where most patients are older and are treated as outpatients. Since January, 1976, 315 patients (mean age 55.5 years) with proven pulmonary tuberculosis have been treated with rifampin (RIF) 600 mg and isoniazid (INH) 300 mg daily for one month, followed by RIF 600 mg and INH 900 mg twice-weekly for another eight months, self-administered except for a few patients. By three months, 95 percent had converted to negative culture. There were only ten failures among 185 patients in whom final results could be assessed. There has been only one relapse during 1-21 months of follow-up in 175 patients. Serious side effects were few: six instances of jaundice, two of "flu-like syndrome," and one of thrombocytopenia. This form of initial therapy for tuberculosis is safe, effective, and economical.

Topics: Adolescent; Adult; Aged; Drug Hypersensitivity; Humans; Isoniazid; Jaundice; Middle Aged; Rifampin; Thrombocytopenia; Time Factors; Tuberculosis, Pulmonary; Vomiting

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; Diarrhea; Ethionamide; Female; Humans; Isoniazid; Middle Aged; Renal Dialysis; Rifampin; Skin Manifestations; Tuberculosis, Pulmonary; Vomiting

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

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