A 2-month regimen of isoniazid,
rifampin, and pyrazinamide (2HRZ) has been used for LTBI treatment in Portugal for over 20 years.
For
rifampin, the corresponding MIC values were 0.0695 [+ or -] 0.0276 [micro]g/mL and 0.0453 [+ or -] 0.0223 [micro]g/mL, representing a 1.53-fold higher value in the relapse group.
A study, conducted by American Thoracic Society, stated that the findings were particularly encouraging because they suggest that at a high enough dose of daily
rifampin may reduce the period of the treatment.
Genotypic assessment of isoniazid and
rifampin resistance in Mycobacterium tuberculosis: a blind study at reference laboratory level.
We performed a nonrandomized, open-label, pilot study of
rifampin pharmacokinetics in 6 HIV-infected adults (aged 18 to 55 years) who were naive to antiretroviral therapy and were receiving HIV care at the Partnership Comprehensive Care Practice (Philadelphia, PA).
The isolate in this case did not conform to previous findings, as the isolate was susceptible to
rifampin but resistant to INH in two reference labs.
The patient was discharged on
rifampin, ethambutol, and prednisone eight days after the biopsy results came back.
Compliance * ([dagger]) scheduled ([section]) Active TB cases (n = 11): completion of 6-month treatment for active TB disease with RIF, INH, and PZ * 11 94 132 140 28 4 93 124 133 37 ([paragraph]) 5 91 128 140 28 7 90 126 140 28 8 92 133 145 29 9 96 149 155 31 10 93 121 130 26 12 90 117 130 26 13 91 127 140 28 14 93 125 135 27 15 93 130 140 28 All 92 1,412 1,528 -- LTBI patients (n = 6): completion of 4-month treatment for LTBI with RIF 16 86 94 110 22 17 88 96 110 22 18 88 97 110 22 19 85 93 110 22 20 87 95 110 22 21 91 100 110 22 All 87 575 660 -- Abbreviations: INH = Isoniazid; LTBI = latent TB infection; PZA = Pyrazinamide; RIV =
Rifampin. * Percentage of recommended doses taken.
* Our patient was discharged from the hospital after 2 weeks on an anti-TB medication regimen of INH,
rifampin, and pyrazinamide, along with pyridoxine and a tapering dose of dexamethasone.
Seventy-two of 79 treatment eligible patients accepted the offer of treatment, which was three months of daily isoniazid and
rifampin. Eleven patients discontinued treatments after starting, all within the first month of treatment.
Rifampin induces hepatic and intestinal CYP3A4 resulting in protracted difficulty in maintaining therapeutic drug levels of calcineurin inhibitors (CNI), inhibitors of the mammalian target of Rapamycin (MTOR), and corticosteroids [11, 12].
(5-7) In four out of six randomized, controlled trials, ofloxacin was the quinolone used in combination with
rifampin. In three of these studies, the results were similar between the quinolone and the non-quinolone arms regarding initial treatment success and probability of relapse.