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. 2011 Nov;15(11):1485-9, i.
doi: 10.5588/ijtld.11.0068.

Experience with rifabutin replacing rifampin in the treatment of tuberculosis

D J Horne  1 , C Spitters, M Narita
Affiliations

Experience with rifabutin replacing rifampin in the treatment of tuberculosis

D J Horne et al. Int J Tuberc Lung Dis. 2011 Nov.

Abstract

Setting: The use of a rifamycin in anti-tuberculosis treatment regimens is crucial for shortening treatment and achieving favorable outcomes. Rifampin (RMP) is the recommended rifamycin, although adverse effects (AEs) may require its discontinuation. The use of rifabutin (RFB), a rifamycin with activity against Mycobacterium tuberculosis, in patients with an RMP-related AE has not been well studied.

Objective: To review our experience with RFB in tuberculosis (TB) treatment.

Methods: We included TB patients who received RFB in their treatment regimens from 2003 to 2009. We evaluated the indications for RFB and, if applicable, the likelihood that RMP caused an AE. We identified RMPrelated AEs associated with RFB intolerance.

Results: One hundred subjects were included. The indications for RFB use were RMP-related AE (57%), con- current antiretroviral therapy (21%), potential/actual interaction with other medications (14%), and as part of an alternative regimen in liver disease (8%). Nineteen patients experienced an AE while taking RFB. Among patients with a prior RMP-related AE, 80% of whom were successfully treated with RFB, only a dermatologic AE was associated with subsequent RFB intolerance.

Conclusions: Our study suggests that RFB is well tolerated by patients who develop RMP-related AEs. There may be an increased risk for RFB-related AE in patients who experienced RMP-related dermatologic events.

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Conflict of interest statement

Funding/financial disclosures: The authors have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in the article.

Figures

Figure
Figure
Diagram of study patients and outcome according to development of rifabutin adverse effect (AE). “Other indication” is defined as an indication for rifabutin other than a rifampin-related AE including concurrent anti-retroviral therapy (ART) use, potential or actual interaction with other patient medications, or as part of a liver-sparing regimen due to underlying liver disease.
See this image and copyright information in PMC

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