Antimicrobial Activity of Rifabutin

Kunin, Calvin M.

doi:10.1093/clinids/22.supplement_1.s3

Cited by 115 publications

(114 citation statements)

References 65 publications

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“…The DNA sequences of the rpoB whole gene demonstrated that all of the 362 rifamycin-resistant isolates had missense mutations in the rpoB entire gene, while 30 susceptible isolates and 1 reference strain (strain H37Rv) of M. tuberculosis had no mutations in the rpoB whole gene, which was in line with the previous findings that the susceptibility to rifampin and that to rifabutin in M. tuberculosis are closely correlated with mutation of the rpoB gene (9,12,18). Furthermore, more than 95% of RIF r isolates in our study possessed mutations inside the RRDR of the rpoB gene, which was consistent with the data reported by previous researchers (10,17,11).…”

Section: Discussionsupporting

confidence: 87%

The Beginning of therpoBGene in Addition to the Rifampin Resistance Determination Region Might Be Needed for Identifying Rifampin/Rifabutin Cross-Resistance in Multidrug-Resistant Mycobacterium tuberculosis Isolates from Southern China

Tan

Zhao³

et al. 2012

J Clin Microbiol

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We aimed to study the distribution and contribution of mutations in the rpoB whole gene in rifampin-resistant/rifabutinresistant (RIF r /Rfb r ) (or RIF/Rfb cross-resistant) clinical Mycobacterium tuberculosis isolates. One standard M. tuberculosis strain (H37Rv) and 392 other clinical M. tuberculosis isolates mainly from Guangdong Province of China whose susceptibilities to rifampin (RIF), rifabutin (Rfb), streptomycin (SM), ethambutol (EMB), and isoniazid (INH) were previously determined were subjected to DNA sequencing of their rpoB whole genes. H37Rv and the 30 drug-susceptible clinical isolates had no mutations in rpoB whole genes. In 43 rifampin-resistant/rifabutin-susceptible (RIF r /Rfb s ) isolates, the most frequent mutation codons were 516 (62.80%), 526 (14.0%), and 533 (6.98%), but codon 531 had no mutation. Twenty-one of the 43 isolates (48.84%) had single mutations of H526L, H526S, D516V, D516Y, and D516F. In 319 RIF r /Rfb r isolates, the most frequent mutation codons were 531 (73.7%) and 526 (18.8%); the mutation frequency for codon 516 was 2.5%, and that for codon 533 was only 0.31%. A total of 82.8% ( A ccording to the data reported by the World Health Organization (WHO) in 2010, an estimated 440,000 cases of multidrug-resistant tuberculosis (MDR-TB) (primary and acquired) arose in 2008. Among all incident TB cases globally, 3.6% are estimated to have MDR-TB (19), so a series of new drugs or alternatives for treatment of MDR-TB has been recommended by WHO since 2008 (20). Rifabutin (Rfb) has been one of the most efficacious drugs and the first-line oral agent recommended by WHO for MDR-TB, but Rfb sometimes has cross-resistance to rifampin (RIF) (2, 4, 15), which implies that the characterization of rpoB mutations in Rfb-resistant (Rfb r ) isolates is not completely the same as that of rpoB mutations in RIF-resistant (RIF r ) isolates. There have been few data supporting this conjecture to this day because of a lack of characterization of rpoB mutations in Rfb r clinical Mycobacterium tuberculosis isolates, so it is very hard to identify the Rfb r isolates from RIF r isolates, even though so many molecular assays for prediction of rifampin susceptibility have been established (8,1,13,3,5). Furthermore, phenotypic drug susceptibility testing is too time-consuming, which is a tremendous obstacle for MDR-TB therapy with rifabutin.According to the results of research presented previously, the mechanism of resistance to rifampin and rifabutin is commonly amino acid exchange in the ␤ subunit (rpoB) of the DNA-directed RNA polymerase. So, the rpoB mutations in M. tuberculosis isolates, whose susceptibility to rifampin, rifabutin, and isoniazid had been previously determined, were characterized after their rpoB whole genes were sequenced.

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Section: Discussionsupporting

confidence: 87%

The Beginning of therpoBGene in Addition to the Rifampin Resistance Determination Region Might Be Needed for Identifying Rifampin/Rifabutin Cross-Resistance in Multidrug-Resistant Mycobacterium tuberculosis Isolates from Southern China

Tan

Zhao³

et al. 2012

J Clin Microbiol

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“…RFB has been proposed as an alternative to RIF in the treatment of TB in transplant patients. It is as effective as RIF 41 and allows better control of plasma concentrations of immunosuppressants; as a result, it reduces the risk of acute rejection. 42 However, although drug interactions are less of a problem in comparison with RIF, they may still occur, and close monitoring of immunosuppressants is necessary.…”

Section: Discussionmentioning

confidence: 99%

Acute liver failure due to antitubercular therapy: Strategy for antitubercular treatment before and after liver transplantation

et al. 2010

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The standard antitubercular treatment (ATT), which consists of isoniazid (INH), rifampicin (RIF), ethambutol, and pyrazinamide (PZA), is the best available treatment for tuberculosis (TB). However, the hepatotoxicity of INH and PZA can be severe, and even after drug withdrawal, patients may require liver transplantation (LT). In these cases, the strategy for the treatment of TB is poorly defined. Between 1986 and 2008, 14 patients presented at our department with severe hepatitis secondary to INH and PZA treatment. Four of these patients were immunosuppressed: 2 after renal transplantation and 2 because of human immunodeficiency virus infection. In seven of the 14 patients an alternative ATT was begun on admission, which was well tolerated. Hepatitis improved spontaneously in 5 patients, and alternative ATT was continued for 9.3 6 4.2 months; 1 patient deteriorated and underwent LT, and 1 patient died. ATT was stopped definitively in 2 patients. Six patients required urgent LT, and alternative ATT was started after transplantation and was successful. Five patients receiving RIF had an episode of acute rejection. In conclusion, hepatitis secondary to ATT can be successfully treated with alternative anti-TB regimens. The use of RIF in LT patients may lead to acute rejection. RIF should therefore be avoided in these patients.

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“…The incidence of analgesic nephropathy decreased substantially in all countries after the banning of phenacetin, 2 with the decrease in the countries that banned the drug later following exactly the time course observed earlier in Australia. An evaluation of all the epidemiologic studies of nonnarcotic analgesics 3 revealed no evidence that combination drugs are more nephrotoxic than single analgesics at equipotent doses provided they do not contain phenacetin. The case-control studies show a very uniform picture: odds ratios for analgesics containing phenacetin are extremely high (up to 19), whereas the odds ratios for single analgesics and for combination drugs (without phenacetin) are in the same range (i.e., 2 to 3) ( Table 2 of the article).…”

Section: Analgesic Nephropathymentioning

confidence: 99%

“…Several experimental studies [1][2][3] have shown the difficulty of inducing renal papillary necrosis with single analgesics such as phenacetin, paracetamol, and aspirin, in contrast to the ease of doing so with such analgesic mixtures as aspirin, phenacetin, and caffeine; aspirin, acetaminophen, and caffeine; and aspirin, salicylamide, and caffeine. Furthermore, Duggin 4 and others have demonstrated the synergistic nephrotoxic effect of the prostaglandin H synthasedependent co-oxidation of acetaminophen to a cytotoxic metabolite with the capacity of aspirin to deplete renal glutathione in animals.…”

Section: Analgesic Nephropathymentioning

confidence: 99%

“…2,3 Moreover, rifabutin has an additive bactericidal effect when combined with amoxicillin or metronidazole and selects for a low number of resistant H. pylori mutants. 2 These laboratory findings led to an open pilot study to assess the in vivo efficacy and tolerance of rifabutin in the treatment of H. pylori infection.…”

Section: Who Will Pay For Graduate Medical Education?mentioning

confidence: 99%

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