Characteristics of and treatment outcomes in rifampicin-intolerant patients
BACKGROUND: Rifampicin (RIF) is considered the backbone of TB treatment, but adverse effects often limit its use. METHODS: This retrospective cohort study examined patients treated for TB disease at our institution, and compared those who received RIF to those who were intolerant to RIF. RESULTS: A...
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International Union Against Tuberculosis and Lung Disease (The Union)
2024-04-01
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| Series: | IJTLD Open |
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| Online Access: | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000004/art00003 |
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| author | R. Mangat S.K. Brode H.K. Mah M.S. Brar N.F. Sabur |
| author_facet | R. Mangat S.K. Brode H.K. Mah M.S. Brar N.F. Sabur |
| author_sort | R. Mangat |
| collection | DOAJ |
| description | BACKGROUND: Rifampicin (RIF) is considered the backbone of TB treatment, but adverse effects often limit its use. METHODS: This retrospective cohort study examined patients treated for TB disease at our institution, and compared those who received RIF to those who were intolerant to RIF. RESULTS: A total of 829 patients were included. Seventy-six patients (9%) were intolerant to RIF. Patients with RIF intolerance were significantly older (median age: 67 years, IQR 50–78 vs. 48 years, IQR 31–70; P < 0.0001), and were more likely to be female (57% vs. 41%; P = 0.01) and have concurrent diabetes mellitus (37.3% vs. 19%; P < 0.0001) compared to those who tolerated RIF. RIF intolerance was most commonly due to transaminitis (25%), cytopenia (14.5%), rash (17.1%) and gastro-intestinal intolerance (7.8%). Twenty patients were subsequently challenged with rifabutin, and this was successful in 70%. The mean treatment duration was significantly longer in patients who were intolerant to RIF (335 vs. 270 days; P < 0.001). There was no significant difference in treatment outcomes. CONCLUSION: RIF intolerance is more common in older patients, females, and those with concurrent diabetes mellitus. Patients who could not tolerate RIF had a longer duration of therapy, but no difference in treatment outcomes. When attempted, rifabutin was well tolerated in most patients with a previous RIF-related adverse event. |
| format | Article |
| id | doaj-art-0a9f7d66654840f2be6327ba6e96d070 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-0a9f7d66654840f2be6327ba6e96d0702025-01-21T10:36:56ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-04-011416016510.5588/ijtldopen.23.04663Characteristics of and treatment outcomes in rifampicin-intolerant patientsR. Mangat0S.K. Brode1H.K. Mah2M.S. Brar3N.F. Sabur4West Park Healthcare Centre, York, ON,Department of Respirology, Toronto Western Hospital, West Park Healthcare Centre, Toronto, ON,West Park Healthcare Centre, York, ON,Surgery, University of Toronto, Toronto, ON,Departments of Medicine, andBACKGROUND: Rifampicin (RIF) is considered the backbone of TB treatment, but adverse effects often limit its use. METHODS: This retrospective cohort study examined patients treated for TB disease at our institution, and compared those who received RIF to those who were intolerant to RIF. RESULTS: A total of 829 patients were included. Seventy-six patients (9%) were intolerant to RIF. Patients with RIF intolerance were significantly older (median age: 67 years, IQR 50–78 vs. 48 years, IQR 31–70; P < 0.0001), and were more likely to be female (57% vs. 41%; P = 0.01) and have concurrent diabetes mellitus (37.3% vs. 19%; P < 0.0001) compared to those who tolerated RIF. RIF intolerance was most commonly due to transaminitis (25%), cytopenia (14.5%), rash (17.1%) and gastro-intestinal intolerance (7.8%). Twenty patients were subsequently challenged with rifabutin, and this was successful in 70%. The mean treatment duration was significantly longer in patients who were intolerant to RIF (335 vs. 270 days; P < 0.001). There was no significant difference in treatment outcomes. CONCLUSION: RIF intolerance is more common in older patients, females, and those with concurrent diabetes mellitus. Patients who could not tolerate RIF had a longer duration of therapy, but no difference in treatment outcomes. When attempted, rifabutin was well tolerated in most patients with a previous RIF-related adverse event.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000004/art00003tuberculosis treatmenttreatment intolerancerifrifabutinadverse effects |
| spellingShingle | R. Mangat S.K. Brode H.K. Mah M.S. Brar N.F. Sabur Characteristics of and treatment outcomes in rifampicin-intolerant patients IJTLD Open tuberculosis treatment treatment intolerance rif rifabutin adverse effects |
| title | Characteristics of and treatment outcomes in rifampicin-intolerant patients |
| title_full | Characteristics of and treatment outcomes in rifampicin-intolerant patients |
| title_fullStr | Characteristics of and treatment outcomes in rifampicin-intolerant patients |
| title_full_unstemmed | Characteristics of and treatment outcomes in rifampicin-intolerant patients |
| title_short | Characteristics of and treatment outcomes in rifampicin-intolerant patients |
| title_sort | characteristics of and treatment outcomes in rifampicin intolerant patients |
| topic | tuberculosis treatment treatment intolerance rif rifabutin adverse effects |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000004/art00003 |
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