Rifampin

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- Discussion:
    - for primary TB, treatment of assymptomatic carriers of N. meningitidis to eliminate meningococci from the nasopharynx;
    - also used in combination with other agents (cipro, levofloxacin, zyvox) for treatment of staphyloccocus infections;
    - it inhibits bacterial DNA dependent RNA polymerase activity;
    - note that rifampin should be administered 1hr before, or 2hr after a meal;
    - contraindicated with a h/o of hypersensitivity to rifampin;
    - use with caution in patients taking coumadin (incr requirments), liver dz,
    - use w/ caution with isoniazid (increased hepatotoxicty);
    - note: diffusion from blood into CSF adequate w/ or w/o Inflammation;
    - dosing regimens for patients with renal insufficiency: (for 70 kg Adult)
            - gm/dosing interval in hours: CrCl: >80:0.3-0.6/24;  50-79:0.3-0.6/24; 30-49: 0.3-0.6/24;   10-29: 0.3-0.6/24;
            - 6-30% of drug will be excreted in to urine (w/ nl RF(x))
    - rifampin w/ cipro / levaquin:
            - Two-stage treatment of chronic staphylococcal orthopaedic implant-related infections using vancomycin impregnated PMMA spacer and rifampin containing antibiotic protocol.
            - Efficacy of linezolid alone and in combination with rifampin in staphylococcal experimental foreign-body infection.
            - Bactericidal activity of the combination of levofloxacin with rifampin in experimental prosthetic knee infection in rabbits due to methicillin-susceptible Staphylococcus aureus.
            - Antagonistic effect of rifampin on the efficacy of high-dose levofloxacin in staphylococcal experimental foreign-body infection.
            - Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: a randomized controlled trial. Foreign-Body Infection (FBI) Study Group.
            - Levofloxacin plus rifampicin conservative treatment of 25 early staphylococcal infections of osteosynthetic devices for rigid internal fixation.
    - adult dosing:
            - pulmonary TB: 600mg PO qd;
            - for meningococcal carriers: 600mg PO qd;
    - peds: meningococcus prophylaxis: 10 mg/kg/day qd x 3 days;
    - supplied: tab 300 mg;

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Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis.

Efficacy of Daptomycin in Implant-Associated Infection due to Methicillin-Resistant Staphylococcus aureus (MRSA): The Importance of Combination with Rifampin.

Linezolid alone or combined with rifampin against methicillin-resistant Staphylococcus aureus in experimental foreign-body infection.



Impact of biofilm on the in vitro activity of vancomycin alone and in combination with tigecycline and rifampicin against Staphylococcus aureus.

Oral step-down therapy is comparable to intravenous therapy for Staphylococcus aureus osteomyelitis.

The bactericidal effects of anti-MRSA agents with rifampicin and sulfamethoxazole-trimethoprim against intracellular phagocytized MRSA.

Treatment of staphylococcal prosthetic joint infections with debridement, prosthesis retention and oral rifampicin and fusidic acid.