Rifampin
From IDWiki
Background
- Inhibits bacterial DNA-dependent RNA polymerase
- Never given alone due to rapid resistance
Dosing
- As adjunct to fluoroquinolone for Staphylococcus aureus:
- Weight <60 kg: 600 mg p.o. daily
- Weight >60 kg: 450 mg p.o. twice daily
Safety
- Avoid in liver failure
Adverse Effects
- Orange or red discoloration of body fluids
- Drug-drug interactions, rash, hepatitis, influenza-like illness, neutropenia, and thrombocytopenia
- Drug-drug interactions
- Flu-like syndrome[1], a type III hypersensitivity reaction characterized by fevers, chills, myalgias, and arthalgias usually 1-4 hours (but up to 12 hours) after a dose, and lasts for 8 hours; if rechallenged, can develop hypotension and shock
Drug-Drug Interactions
- Multiple
- Induces CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, and CYP3A
- Other antibiotics include clindamycin, doxycycline, linezolid, moxifloxacin, trimethoprim, and fusidic acid
- ↑ Dhhar G, McColl J, Kitai I, Levy DM, Verstegen RHJ. Rifampin-induced flu-like syndrome with shock in a patient with tuberculosis infection. CMAJ. 2023;195(34):E1151-E1153. DOI: 10.1503/cmaj.230317
References
- ^ Gousia Dhhar, Jeanine McColl, Ian Kitai, Deborah M. Levy, Ruud H.J. Verstegen. Rifampin-induced flu-like syndrome with shock in a patient with tuberculosis infection. Canadian Medical Association Journal. 2023;195(34):E1151-E1153. doi:10.1503/cmaj.230317.
