Rifampin

Farr, Barry M.; Mandell, Gerald L.

doi:10.1016/s0025-7125(16)31449-3

Cited by 54 publications

(19 citation statements)

References 119 publications

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“…Both the emergence of resistance in S. aureus (0.0 to 18.2%) and the occurrence of serious drug-related toxicity (6.6%) were frequent in the intervention group. Resistance to rifampin arises as a result of a missense mutation in the rpoB gene in one of 10 5 staphylococci (158). Given this high and predictable frequency of resistance development, rifampin should not be used in monotherapy.…”

Section: Oral Rifampinmentioning

confidence: 99%

Staphylococcus aureus Infections in Hemodialysis

Vandecasteele

Boelaert

Vriese

2009

Clinical Journal of the American Society of Nephrology

113

103

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Staphylococcus aureus is a formidable pathogen that has the ability to colonize approximately half the dialysis population without any sign of disease but is also capable of causing wound and tissue infections; fulminant septicemia; and chronic, difficult-to-eradicate and often foreign body-related infections. S. aureus is the main cause of infectious morbidity and mortality in hemodialysis patients. This review highlights the importance of S. aureus infections in daily hemodialysis practice from a clinical viewpoint, starting from some key issues in the pathogenesis of staphylococcal infections.

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Section: Oral Rifampinmentioning

confidence: 99%

Staphylococcus aureus Infections in Hemodialysis

Vandecasteele

Boelaert

Vriese

2009

Clinical Journal of the American Society of Nephrology

113

103

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“…Rifampin is highly active against staphylococci, it can be administered orally once daily, and it achieves high levels in tissue, including high intracellular levels in macrophages (4). The drug is used to treat staphylococcal osteomyelitis, but when used as a single agent, emergence of resistance is frequently observed (13).…”

mentioning

confidence: 99%

Relationship between antibiotic concentration in bone and efficacy of treatment of staphylococcal osteomyelitis in rats: azithromycin compared with clindamycin and rifampin

O’Reilly

Kunz

Sande

et al. 1992

Antimicrob Agents Chemother

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We examined the effect of azithromycin 993), a new oral macrolide-like antibiotic, alone and in combination with rifampin, as treatment for experimental staphylococcal osteomyelitis. Clindamycin was used as a comparison drug. Rats (n = 10 to 15 per group) were infected by direct instillation of Staphylococcus aureus into the tibial medullary cavity. After 10 days, 21-day treatments with azithromycin (50 mg/kg of body weight, once daily, by the oral route), rifampin (20 mgtkg, once daily, subcutaneously), or clindamycin (90 mg/kg, three times daily, by the oral route) were started. The drugs were used singly or in combination (azithromycin plus rifampin or cindamycin plus rifampin). Peak azithromycin concentrations in bone were >30 times higher than levels in serum, but the drug had little effect on final bacterial titers (5.13 + 0.46 log1o CFU/g of bone; for controls, 6.54 t 0.28 log1o CFU/g). CUindamycin was more active than azithromycin (3.26 ± 2.14 log1o CFU/g of bone; 20%Yo of sterilized bones), but rifampin was the most active single drug (1.5 + 1.92 loglo CFU/g; 53% of sterilized bones). Therapy with rifampin or clindamycin alone was associated with the emergence of resistance. Rifampin plus azithromycin (0.51 ± 1.08 log1o CFU/g of bone; 80%o of sterilized bones) and rifampin plus clindamycin (0.87 ± 1.34 log1o CFU/g of bone; 66% of sterilized bones) were the most active regimens. Thus, azithromycin is ineffective as a single drug for the treatment of experimental staphylococcal osteomyelitis, despite high levels in bone that markedly exceded the MIC, but it may be an attractive partner drug for rifampin.

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“…Ciprofloxacin and rifampin are potent antistaphylococcal antimicrobial agents (3,4). Unfortunately, a major drawback to the use of rifampin for Staphylococcus aureus infections is that resistance develops rapidly when it is used alone (4).…”

mentioning

confidence: 99%

“…Unfortunately, a major drawback to the use of rifampin for Staphylococcus aureus infections is that resistance develops rapidly when it is used alone (4). This fact relegates the drug to an adjunctive role in such situations.…”

mentioning

confidence: 99%

Ciprofloxacin and rifampin, alone and in combination, for therapy of experimental Staphylococcus aureus endocarditis

Kaatz

Seo

Barriere

et al. 1989

Antimicrob Agents Chemother

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The therapeutic activities of ciprofloxacin (25 mg/kg every 8 h), rifampin (10 mg/kg every 24 h), ciprofloxacin plus rifampin, and vancomycin (17.5 mg/kg every 6 h) were compared by using the rabbit model of Staphylococcus aureus endocarditis. Animals infected with one of two test strains (SA1199 or SA487) were randomized into treatment groups and received 6 days of therapy. For SA1199, ciprofloxacin plus rifampin was most effective at reducing vegetation bacterial counts. For SA487, ciprofloxacin plus rifampin was as effective as vancomycin but' less effective than ciprofloxacin alone. Resistance to ciprofloxacin at 5-and 10-fold the MIC emerged in the test strain in 82 and 55%, respectively, of rabbits infected with SA1199'and receiving ciprofloxacin monotherapy. The combination of ciprofloxacin and rifampin decreased these frequencies to 60% (P = 0.27) and 10% (P = 0.04). No resistance to ciprofloxacin was found in rabbits infected with SA487. We conclude that ciprofloxacin and ciprofloxacin plus rifampin are as efficacious as vancomycin in this model and that combining rifampin with ciprofloxacin may decrease the frequency at which high-level resistance to ciprofloxacin emerges. However, with respect to improved efficacy, the combination of ciprofloxacin and rifampin is unpredictable and may be detrimental.Ciprofloxacin and rifampin are potent antistaphylococcal antimicrobial agents (3, 4). Unfortunately, a major drawback to the use of rifampin for Staphylococcus aureus infections is that resistance develops rapidly when it is used alone (4). This fact relegates the drug to an adjunctive role in such situations.Previous studies have shown monotherapy with ciprofloxacin to be as efficacious as standard therapeutic regimens in experimental methicillin-susceptible and -resistant S. aureus endocarditis (2,7,8). However, we have shown that resistance to ciprofloxacin can emerge during therapy for such infections (8). Resistance to the drug also has developed during treatment of S. aureus infections in humans (5). The effect of combining ciprofloxacin and rifampin for therapy of systemic S. aureus infections, both with respect to improved efficacy and the emergence of resistance to ciprofloxacin, has not been studied. Therefore, we compared the therapeutic activities of these drugs, alone and in combination, with that of vancomycin by using the rabbit model of S. aureus endocarditis. We also evaluated the effect of combining ciprofloxacin and rifampin on the frequency at which resistance to ciprofloxacin emerged in our test strains during therapy. MATERIALS AND METHODSOrganisms. The strains of S. aureus used (SA1199 and SA487) were methicillin-susceptible bloodstream isolates from patients with endocarditis.In vitro studies. The MICs and MBCs of methicillin, * Corresponding author. vancomycin, ciprofloxacin, and rifampin for test strains were determined by a microtiter method, employing cationsupplemented Mueller-Hinton broth (Difco Laboratories, Detroit, Mich.) and an inoculum of 5 x 105 CFU/ml (6). Susceptibilit...

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Rifampin

Cited by 54 publications

References 119 publications

Staphylococcus aureus Infections in Hemodialysis

Staphylococcus aureus Infections in Hemodialysis

Relationship between antibiotic concentration in bone and efficacy of treatment of staphylococcal osteomyelitis in rats: azithromycin compared with clindamycin and rifampin

Ciprofloxacin and rifampin, alone and in combination, for therapy of experimental Staphylococcus aureus endocarditis

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