Early bactericidal activity of high-dose rifampin in patients with pulmonary tuberculosis evidenced by positive sputum smears

Abstract

We studied the early bactericidal activity of twice the standard dose of rifampin in subjects with pulmonary tuberculosis evidenced by positive smears. The observed mean 2-day activity was almost double that reported at the standard dose. Further studies are warranted to establish whether higher rifampin doses might assist in shortening tuberculosis treatment.

FIG. 1.

Serial sputum mean log CFU counts over 5 days of treatment with RMP at 20 mg/kg of body weight. Data are means ± 2 standard errors. There is no strong evidence of departure from a linear trend, as indicated by the fitted straight line.

FIG. 2.

EBA data from studies performed in Hong Kong (3), Nairobi (6), and Cape Town (15-17), including the present study (arrow). For comparison, the doses of RMP are normalized to a patient weighing 50 kg. Data are means ± 2 standard errors. The standard error is calculated using a pooled estimate of standard deviation from all studies, where available, and the number of subjects in the study.