Rifampin-induced Pseudomembranous Colitis with Rectosigmoid Sparing

Yim, Sun Young; Koo, Ja Seol; Kim, Ye Ji; Park, Sang Jung; Kim, Jin Nam; Jung, Sung Woo; Yim, Hyung Joon; Lee, Sang Woo; Choi, Jai Hyun; Kim, Chang Duck

doi:10.5946/ce.2011.44.2.137

Cited by 5 publications

(4 citation statements)

References 14 publications

(19 reference statements)

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“…Anti-tuberculosis drugs are not commonly associated with the development of CDI [2–5]. Recently, FQ have been linked to CDI, particularly those cases caused by polymerase chain reaction (PCR) ribotype 027 [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Emergence of Clostridium difficile infection in tuberculosis patients due to a highly rifampicin-resistant PCR ribotype 046 clone in Poland

Obuch-Woszczatyński

Dubiel²,

Harmanus

et al. 2013

Eur J Clin Microbiol Infect Dis

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Section: Introductionmentioning

confidence: 99%

Emergence of Clostridium difficile infection in tuberculosis patients due to a highly rifampicin-resistant PCR ribotype 046 clone in Poland

Obuch-Woszczatyński

Dubiel²,

Harmanus

et al. 2013

Eur J Clin Microbiol Infect Dis

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“…These results were similar to those of other studies. 14 , 16 , 18 , 20 RFP may have lower capacity to perturb the intestinal bacterial flora than do other antibiotics. 18 …”

Section: Discussionmentioning

confidence: 99%

“… 14 and Yim et al . 16 discussed pseudomembranous colitis (PMC) patients with anti-TB treatment including RFP who improved after termination of the anti-TB medications and had no recurrence after retrying anti-TB agents excluding RFP. We did not statistically prove an association of RFP with CDI through statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Clinical Outcomes of Clostridium difficile Infection after Treatment with Tuberculosis Medication

et al. 2016

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Background/AimsTo determine the incidence and clinical characteristics of tuberculosis (TB) medication-associated Clostridium difficile infection.MethodsThis multicenter study included patients from eight tertiary hospitals enrolled from 2008 to 2013. A retrospective analysis was conducted to identify the clinical features of C. difficile infection in patients who received TB medication.ResultsC. difficile infection developed in 54 of the 19,080 patients prescribed TB medication, representing a total incidence of infection of 2.83 cases per 1,000 adults. Fifty-one of the 54 patients (94.4%) were treated with rifampin. The patients were usually treated with oral metronidazole, which produced improvement in 47 of the 54 patients (87%). Twenty-three patients clinically improved with continuous rifampin therapy for C. difficile infection. There were no significant differences in improvement between patients treated continuously (n=21) and patients in whom treatment was discontinued (n=26).ConclusionsThe incidence of C. difficile infection after TB medication was not low considering the relatively low TB medication dosage compared to other antibiotics. It may not be always necessary to discontinue TB medication. Instead, decisions concerning discontinuation of TB medication should be based on TB status.

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“…Most antituberculosis agents have few effects on intestinal flora, so PMC associated with antituberculosis therapy is very rare [7][8][9][10][11][12]. Although few cases of PMC associated with antituberculosis therapy were seen most A case of pseudomembranous colitis associated with antituberculosis therapy in a patient with tuberculous meningitis ficile, tuberculous meningitis, antituberculosis agents, vancomycin…”

Section: Introductionmentioning

confidence: 99%

A case of pseudomembranous colitis associated with antituberculosis therapy in a patient with tuberculous meningitis

Kim¹,

Jeong²,

Choi³

2014

J Biomed Res

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Pseudomembranous colitis (PMC) is known to be associated with the long-term administration of antibiotics, which alter normal gastrointestinal flora and allow overgrowth of Clostridium difficile. However, antituberculosis agents are rarely reported as a cause of this disease. Besides, most cases of antituberculosis agent-induced PMC have been observed in patients with pulmonary tuberculosis but not with tuberculous meningitis. This report presents a case of PMC associated with antituberculosis therapy in a patient with tuberculous meningitis. A 29-year-old female patient was admitted due to headaches and diplopia that had lasted for 2 weeks. She had not recently received antimicrobial therapy. She was diagnosed with tuberculous meningitis by cerebrospinal fluid findings and neurologic examination, including brain imaging study. She was treated with standard antituberculosis agents (HERZ regimen: isoniazid, ethambutol, rifampicin, and pyrazinamide). After 11 days of HERZ, she developed a fever, sudden widespread skin eruption, and elevation of liver enzymes. Considering adverse drug reactions, antituberculosis agents were stopped. One week later, her symptoms were relieved. Thus, antituberculosis agents were reintroduced one at a time after liver function returned to normal. However, she presented with frequent mucoid, jelly-like diarrhea, and lower abdominal pain. Sigmoidscopy revealed multiple yellowish plaques with edematous mucosa, which were compatible with PMC. She was treated with oral vancomycin considering drug interactions. Symptoms were relieved and did not recur when all antituberculosis agents except pyrazinamide were started again. Therefore, when a patient complains of abdominal pain or diarrhea after initiation of antituberculosis therapy, the physician should consider the possibility of antituberculosis agent-associated PMC.

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Rifampin-induced Pseudomembranous Colitis with Rectosigmoid Sparing

Cited by 5 publications

References 14 publications

Emergence of Clostridium difficile infection in tuberculosis patients due to a highly rifampicin-resistant PCR ribotype 046 clone in Poland

Emergence of Clostridium difficile infection in tuberculosis patients due to a highly rifampicin-resistant PCR ribotype 046 clone in Poland

Incidence and Clinical Outcomes of Clostridium difficile Infection after Treatment with Tuberculosis Medication

A case of pseudomembranous colitis associated with antituberculosis therapy in a patient with tuberculous meningitis

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