Low-level rifampicin-resistant Mycobacterium tuberculosis strains raise a new therapeutic challenge
SourceInternational Journal of Tuberculosis and Lung Disease, 15, 7, (2011), pp. 990-992
Article / Letter to editor
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International Journal of Tuberculosis and Lung Disease
SubjectN4i 1: Pathogenesis and modulation of inflammation NCMLS 1: Infection and autoimmunity; N4i 2: Invasive mycoses and compromised host; N4i 3: Poverty-related infectious diseases; N4i 3: Poverty-related infectious diseases NCEBP 13: Infectious diseases and international health
In an outbreak of multidrug-resistant tuberculosis, the outbreak strain had an Asp516Tyr rpoB gene mutation. Phenotypically, low-level rifampicin (RMP) resistance (minimum inhibitory concentration [MIC] 1-2 mg/l) was observed. Based on drug susceptibility test results, three patients were treated with 12-15 month rifabutin-based regimens and one with a 12-month RMP-based regimen. We retrospectively performed pharmacokinetic calculations to assess the potential for RMP treatment, from which we conclude that MICs for RMP up to 1 mug/ml may be safely overcome by applying 20 mg/kg RMP doses in treatment regimens.
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