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Free Content Low-level rifampicin-resistant Mycobacterium tuberculosis strains raise a new therapeutic challenge [Short communication]

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Abstract:

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 μg/ml may be safely overcome by applying 20 mg/kg RMP doses in treatment regimens.

Keywords: Mycobacterium tuberculosis; multidrug-resistant; rifampicin; rpoB protein; tuberculosis

Document Type: Short Communication

DOI: http://dx.doi.org/10.5588/ijtld.10.0127

Affiliations: 1: Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; National Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment, Bilthoven, The Netherlands 2: Department of Clinical Pharmacy, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands 3: Department of Tuberculosis Control, Municipal Public Health Service, Rotterdam-Rijnmond, Rotterdam, The Netherlands; KNCV Tuberculosis Foundation, The Hague, The Netherlands 4: Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands 5: Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; National Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Department of Clinical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Publication date: July 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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