The use of rifampicin in staphylococcal infections - a review

Kapusnik, Joan E.; Parenti, Francesco; Sande, Merle A.

doi:10.1093/jac/13.suppl_c.61

Cited by 24 publications

(12 citation statements)

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“…Antimicrobial resistance to rifamycins develops rapidly both in vitro and in vivo [65,85,86]. As a consequence, all the three members of the family (i.e.…”

Section: In Vivo Antimicrobial Resistancementioning

confidence: 99%

Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical Potential

2005

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Rifaximin (4-deoxy-4′-methylpyrido[1′,2′-1,2]imidazo- [5,4-c]-rifamycin SV) is a synthetic antibiotic designed to modify the parent compound, rifamycin, in order to achieve low gastrointestinal (GI) absorption while retaining good antibacterial activity. Both experimental and clinical pharmacology clearly show that this compound is a nonsystemic antibiotic with a broad spectrum of antibacterial action covering Gram-positive and Gram-negative organisms, both aerobes and anaerobes. Being virtually nonabsorbed, its bioavailability within the GI tract is rather high with intraluminal and fecal drug concentrations that largely exceed the minimal inhibitory concentration values observed in vitro against a wide range of pathogenic organisms. The GI tract represents, therefore, the primary therapeutic target and GI infections the main indication. The appreciation of the pathogenic role of gut bacteria in several organic and functional GI diseases has increasingly broadened its clinical use, which is now extended to hepatic encephalopathy, small intestine bacterial overgrowth, inflammatory bowel disease and colonic diverticular disease. Potential indications include the irritable bowel syndrome and chronic constipation, Clostridium difficile infection and bowel preparation before colorectal surgery. Because of its antibacterial activity against the microorganism and the lack of strains with primary resistance, some preliminary studies have explored the rifaximin potential for Helicobacter pylori eradication. Oral administration of this drug, by getting rid of enteric bacteria, could also be employed to achieve selective bowel decontamination in acute pancreatitis, liver cirrhosis (thus preventing spontaneous bacterial peritonitis) and nonsteroidal anti-inflammatory drug (NSAID) use (lessening in that way NSAID enteropathy). This antibiotic has, therefore, little value outside the enteric area and this will minimize both antimicrobial resistance and systemic adverse events. Indeed, the drug proved to be safe in all patient populations, including young children. Although rifaximin has stood the test of time, it still attracts the attention of both basic scientists and clinicians. As a matter of fact, with the advancement of the knowledge on microbial-gut interactions in health and disease novel indications and new drug regimens are being explored. Besides widening the clinical use, the research on rifaximin is also focused on the synthesis of new derivatives and on the development of original formulations designed to expand the spectrum of its clinical use.

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“…Antimicrobial resistance to rifamycins develops rapidly both in vitro and in vivo [65,85,86]. As a consequence, all the three members of the family (i.e.…”

Section: In Vivo Antimicrobial Resistancementioning

confidence: 99%

Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical Potential

2005

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“…Antimicrobial resistance to rifamycins develops rapidly both in vitro and in vivo [56, 66, 67]. As a consequence, all the three members of the family (i.e.…”

Section: Antimicrobial Activitymentioning

confidence: 99%

Experimental and Clinical Pharmacology of Rifaximin, a Gastrointestinal Selective Antibiotic

Scarpignato

Pelosini²

2006

Digestion

101

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Rifaximin (4-deoxy-4′-methylpyrido[1′,2′-1,2]imidazo [5,4-c]rifamycin SV) is a product of synthesis experiments designed to modify the parent compound, rifamycin, in order to achieve low gastrointestinal (GI) absorption while retaining good antibacterial activity. Both experimental and clinical pharmacology clearly show that this compound is a non-systemic antibiotic with a broad spectrum of antibacterial action covering Gram-positive and Gram-negative organisms, both aerobes and anaerobes. Being virtually non-absorbed, its bioavailability within the GI tract is rather high with intraluminal and fecal drug concentrations that largely exceed the minimum inhibitory concentration values observed in vitro against a wide range of pathogenic organisms. The GI tract represents therefore the primary therapeutic target and GI infections the main indication. This antibiotic has therefore little value outside the enteric area and this will minimize both antimicrobial resistance and systemic adverse events. Indeed, the drug proved to be safe in all patient populations, including young children. The appreciation of the pathogenic role of gut bacteria in several organic and functional GI diseases has increasingly broadened its clinical use, which is now extended to hepatic encephalopathy, small intestine bacterial overgrowth, inflammatory bowel disease and colonic diverticular disease.

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“…vancomycin is the drug of choice for these infections, certain infants with these infections do not respond to treatment with vancomycin alone or in combination with an aminoglycoside. Rifampin is an antistaphylococcal antibiotic which has been used in combination with a semisynthetic penicillin or vancomycin for severe staphylococcal infections (19). Several studies have shown antibiotic combinations with rifampin to be synergistic, resulting in enhancement of killing and improvement of clinical response (5,10,13,22,34), while other studies have found these combinations to be antagonistic (35).…”

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confidence: 99%

Use of intravenous rifampin in neonates with persistent staphylococcal bacteremia

Tan

Mason

et al. 1993

Antimicrob Agents Chemother

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Ten neonates with persistent staphylococcal bacteremia (positive blood cultures for 25 days despite appropriate antibiotic therapy) received intravenous (i.v.) rifampin in combination with vancomycin with or without aminoglycoside. Their mean birth weight and length of gestation were 900 g and 27 weeks, respectively.Their ages at the time of infection ranged from 6 to 64 days (mean, 26 days). The staphylococcal isolates were methicillin-resistant Staphylococcus aureus (five isolates), methicillin-susceptible S. aureus (two isolates), and coagulase-negative staphylococci (three isolates). The mean number of bacteremia days prior to administration of i.v. rifampin was 8.3 (range, 5 to 15 days), despite a mean peak vancomycin concentration of 33 ,ug/ml. The dosing of rifampin varied from 2.5 to 10 mg/kg of body weight every 12 h. The mean duration of the rifampin course was 9.7 days (range, 3 to 16 days). Of the 10 neonates, 8 (80%) had sterile blood cultures within 24 h, 1 (10%N) had a sterile blood culture within 48 h, and 1 (10%S) had a sterile blood culture within 5 days of being placed on i.v. rifampin. No adverse effects were noted in this small group of infants. Seven of the 10 neonates survived; three died from unrelated complications. The MIC ranges of amikacin, vancomycin, and rifampin for the isolates were 2.0 to 16, 0.5 to 2.0, and 0.0013 to 0.04 ,Ig/ml, respectively. We also studied eight infants, with a mean age of 23 days, who were receiving i.v. or oral rifampin at a dose of 10 mg/kg/day. For i.v. administration, the peak serum concentration of rifampin (mean standard deviation) was 4.02 1.22 ,Lg/ml.The mean trough level at 12 h postinfusion was 1.11 + 0.48 ;ig/ml. For oral administration, the concentrations of rifampin in serum ranged from 0.59 to 2.86 p.g/ml (mean, 1.86 0.96 pLg/ml) at 2 h postingestion, increasing to a peak concentration of 2.8 ,a.g/ml at 8 h postingestion. The mean 12-h postingestion level was 0.77 0.03 pg/ml. From the study of this limited series of neonates, rifampin appears to be a safe and effective addition to therapy when staphylococcal bacteremia is persistent despite vancomycin treatment.

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The use of rifampicin in staphylococcal infections - a review

Cited by 24 publications

References 0 publications

Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical Potential

Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical Potential

Experimental and Clinical Pharmacology of Rifaximin, a Gastrointestinal Selective Antibiotic

Use of intravenous rifampin in neonates with persistent staphylococcal bacteremia

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