Drug interactions between rifamycin antibiotics and hormonal contraception: a systematic review

Simmons, Katharine B.; Haddad, Lisa; Nanda, Kavita; Curtis, Kathryn M.

doi:10.1111/1471-0528.15027

Cited by 38 publications

(26 citation statements)

References 27 publications

(109 reference statements)

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“…intrauterine devices or condoms) which are not adversely affected by rifamycins, as hormonal contraception cannot be relied upon during tuberculosis treatment. 85 Pregnancy testing should be performed prior to provision of therapy so that pregnant adolescents can be appropriately referred for prenatal care. Testing for other sexually-transmitted infections should be offered at the time adolescents are tested for HIV infection, as incidence rates are usually highest in this age group.…”

Section: Specific Considerations For Adolescents During Tuberculosis mentioning

confidence: 99%

Adolescent tuberculosis

Snow

Cruz

Seddon

et al. 2020

The Lancet Child & Adolescent Health

116

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Adolescence is characterised by a dramatic increase in the incidence of tuberculosis, a fact that has been appreciated since the early 20 th century. The majority of the world's adolescents live in low and middle-income countries where tuberculosis remains common, and where they comprise one quarter of the population. Despite this, adolescents have not yet been addressed as a distinct population in tuberculosis policy or within tuberculosis treatment services, and emerging evidence suggests that current models of care do not meet their needs.This article reviews current knowledge about tuberculosis in adolescence with a focus on the management of infection and disease, including HIV co-infection and rifampicin-resistant tuberculosis. Recent progress in vaccine development is outlined and important directions for future research are highlighted. Search strategy and selection criteriaThis was a narrative review of the literature on adolescent tuberculosis, informed by expert opinion and clinical experience. We reviewed the English-and Spanish-language literature for studies on adolescent tuberculosis to identify case series documenting clinical presentation and treatment outcomes. We searched PubMed with the following string on 19August 2019: ('tuberculosis'[Title]) AND ('adolescent'[TIAB]). The search returned 210 results, of which 11 were eligible for inclusion (Table 1), and we identified three additional studies from reference lists, for a total of 14 studies. Studies reporting solely on prevalence or where data from adolescents was aggregated with those of younger children or adults were excluded. Data were extracted regarding major site(s) of disease, percent of adolescents with microbiologic confirmation, adverse drug reactions, and final treatment outcomes.

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Section: Specific Considerations For Adolescents During Tuberculosis mentioning

confidence: 99%

Adolescent tuberculosis

Snow

Cruz

Seddon

et al. 2020

The Lancet Child & Adolescent Health

116

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“…The study population comprised 364 women with a median age of 23 [interquartile range (IQR) [19][20][21][22][23][24][25][26][27][28][29]. Of these, 40…”

Section: Resultsmentioning

confidence: 99%

“…It has previously been suggested that use of antibiotics in general might influence the use of oral contraceptives [20,21]. With the exception of rifampicin, which has been shown to confer a risk of oral contraceptive failure [22], this alleged risk has largely been 'debunked' [23]. Importantly, the putative mechanism for such interactions is that of altered enterohepatic recirculation of hormones [24] and not of induction of CYP enzymes.…”

Section: Discussionmentioning

confidence: 99%

Use of Dicloxacillin and Risk of Pregnancy among Users of Oral Contraceptives

Pottegård

Broe

Stage

et al. 2018

Basic Clin Pharma Tox

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The antibiotic dicloxacillin has been shown to induce drug-metabolizing CYP enzymes to a clinically relevant extent. In this study, we investigated whether the use of dicloxacillin confers an increased risk of unwanted pregnancy among oral contraceptive users. The study population comprised Danish women falling pregnant (1997-2015) during oral contraceptive use, defined as having filled a prescription for an oral contraceptive within 120 days both before and after the estimated date of conception. Data were analysed using a case-crossover approach. For each woman, we assessed the use of dicloxacillin preceding the date of conception and during 10 previous control periods and estimated the odds ratio for such unintended pregnancies associated with the use of dicloxacillin. Among 364 women using dicloxacillin prior to conception, 40 (11%) were exposed to dicloxacillin at the time of conception, yielding an odds ratio (OR) associating use of dicloxacillin to unintended pregnancy of 1.18 (95% CI 0.84-1.65). Supplementary and sensitivity analyses generally returned similar estimates, except for a slightly increased risk among users of progestogen-only oral contraceptives (OR 1.83, 95% CI 0.63-5.34). Analysis of other antibiotics as negative controls yielded results close to unity (ORs ranging from 0.83 to 1.13). In conclusion, our study found no evidence for an increased risk of oral contraceptive failure when using dicloxacillin. However, acknowledging study limitations, we suggest the use of supplementary barrier methods during treatment with dicloxacillin, until our findings are confirmed in further studies.

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“…5,12 Strikingly, in 73% of the cases included in the systematic review by Sobhy et al, the pregnancy occurred after TB was diagnosed, rather than TB being diagnosed in the course of the pregnancy. 5 Rifamycins adversely affect the metabolism of contraceptive hormones, 27 and women being treated for TB should be provided information about and access to effective contraception (such as injectable depot medroxyprogesterone acetate, which does not appear to be affected by rifampicin, either copper or intrauterine devices, or barrier methods 28 ). There is limited evidence on the impact of rifampicin on the effectiveness of progesterone-only contraception compared to combined oral contraceptive pill.…”

Section: Consequences Of Tb In Pregnancymentioning

confidence: 99%

Tuberculosis in pregnant women and neonates: A meta-review of current evidence

Snow

Bekker

Huang

et al. 2020

Paediatric Respiratory Reviews

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Drug interactions between rifamycin antibiotics and hormonal contraception: a systematic review

Abstract: Rifampin and rifabutin reduce systemic exposure of oral contraceptives, but no studies have evaluated pregnancy risk.

Cited by 38 publications

References 27 publications

Adolescent tuberculosis

Adolescent tuberculosis

Use of Dicloxacillin and Risk of Pregnancy among Users of Oral Contraceptives

Tuberculosis in pregnant women and neonates: A meta-review of current evidence

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