Rifampin: Difference between revisions

Latest revision as of 13:29, 10 December 2023

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
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

[1] 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

[1]

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+== Background ==
 * Inhibits bacterial DNA-dependent RNA polymerase
 * Never given alone due to rapid resistance
-* Adverse effects include drug-drug interactions, rash, hepatitis, influenza-like illness, neutropenia, and thrombocytopenia
+== Dosing ==
-* Avoid in liver failure
+* 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
+* [[Adverse drug reaction::drug-drug interactions|Drug-drug interactions]], [[Adverse drug reaction::rash]], [[Adverse drug reaction::hepatitis]], [[Adverse drug reaction::influenza-like illness]], [[Adverse drug reaction::neutropenia]], and [[Adverse drug reaction::thrombocytopenia]]
+* Drug-drug interactions
+* Flu-like syndrome<ref>Dhhar G, McColl J, Kitai I, Levy DM, Verstegen RHJ. Rifampin-induced flu-like syndrome with shock in a patient with tuberculosis infection. <abbr>''CMAJ.''</abbr> 2023;195(34):E1151-E1153. DOI: [https://doi.org/10.1503/cmaj.230317 10.1503/cmaj.230317]</ref>, 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
+* Other antibiotics include [[clindamycin]], [[doxycycline]], [[linezolid]], [[moxifloxacin]], [[trimethoprim]], and [[fusidic acid]]
 [[Category:Rifamycins]]