has among the highest rates of antibiotic resistance encountered in hospitals. New therapies are critically needed. We found that rifabutin has previously unrecognized hyperactivity against most strains of Here we review the pharmacology and adverse effects of rifabutin to inform potential oral dosing strategies in patients with infections. Rifabutin demonstrates dose-dependent increases in blood levels up to 900 mg per day, but plateaus thereafter. Furthermore, rifabutin induces its own metabolism after prolonged dosing, lowering its blood levels. Pending future development of an intravenous formulation, a rifabutin oral dose of 900-1200 mg per day for 1 week is a rational choice for adjunctive therapy of infections. This dosage maximizes AUC to drive efficacy while simultaneously minimizing toxicity. Randomized controlled trials will be needed to definitively establish the safety and efficacy of rifabutin to treat infections.
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http://dx.doi.org/10.1093/ofid/ofaa460 | DOI Listing |
bioRxiv
December 2024
Division of Infectious Diseases, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
, a leading non-tuberculous mycobacterium (NTM) pathogen, causes chronic pulmonary infections, particularly in individuals with underlying lung conditions or immunosuppression. Current treatments involve prolonged multi-drug regimens with poor outcomes and significant side effects, highlighting the urgent need for improved therapies. Using a BALB/c mouse model of chronic pulmonary disease, we evaluated the efficacy of individual antibiotics-clarithromycin, clofazimine, and rifabutin-and combination regimens including clarithromycin+bedaquiline and clarithromycin+clofazimine+bedaquiline.
View Article and Find Full Text PDFCureus
November 2024
Cardiology, Tampa General Hospital, Tampa, USA.
Atypical mycobacterium infections are an uncommon cause of cutaneous infection, and they are especially rare infections of the facial region. Immunocompromised patients, such as transplant patients, are at higher risk for infections of this nature with concurrent hematogenous spread to other organ systems. We report a patient with a previous heart transplant who developed an atypical mycobacterium infection of the skin with possible dissemination to the lung.
View Article and Find Full Text PDFJ Pediatr Gastroenterol Nutr
January 2025
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA.
Zhonghua Yu Fang Yi Xue Za Zhi
November 2024
Department of Clinical Laboratory, Shenzhen Third People's Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen518112, China.
To evaluate the clinical value of targeted next generation sequencing (tNGS) in diagnosing rifampicin and rifabutin resistance in tuberculosis patients. In this retrospective cohort study, 119 culture-positive Mycobacterium (MTB) strains from tuberculosis patients in Shenzhen Third People's Hospital from 2020 to 2023 were collected, then tNGS was performed to detect mutations of rpoB gene. Fourteen different types of rpoB gene mutation were detected in 46 mutation MTB strains, including 43 resistance related mutations and 3 synonymous mutations at codon 529.
View Article and Find Full Text PDFJ Appl Microbiol
November 2024
Center for Microbiology, VIB-KU Leuven, 3001 Leuven, Belgium.
Aims: We aimed to investigate the molecular mechanisms underlying the survival of Mycobacterium abscessus when faced with antibiotic combination therapy. By conducting evolution experiments and whole-genome sequencing (WGS), we sought to identify genetic variants associated with stress response mechanisms, with a particular focus on drug survival and resistance.
Methods And Results: We conducted evolution experiments on M.
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