Intermittent Therapy with Rifampin Once a Week in Advanced Pulmonary Tuberculosis

¹ Academisch Ziekenhuis, Pellenberg, University of Leuven, Belgium
² Sanatorium of Makala, Kinshasa, Zaire
³ Institut de Médecine Tropicale, Kinshasa, Zaire
⁴ Hôpital Civil, Charleroi, Belgium

In 38 retreatment patients, rifampin 30 mg/kg plus ethambutol 100 mg/kg was given once weekly for periods from four to ten months, followed by a regimen with ethionamid 1 gr plus thiocarlide 6 gr three days a week for three to eight months. By the 14th week, 36 patients were negative in the cultures. Out of 31 patients who had bacteriologic control after one year, two patients were found positive in cultures.

A pharmacologic study performed during the first week, when rifampin was administered three times on alternate days, revealed high and long lasting rifampin serum levels, covering 24 hour periods, but showed no accumulation of the drug. A concomitant increase of total and conjugated bilirubin in the serum was observed on the days of rifampin administration. The renal and hepatic function tests after ten weeks of therapy showed no alterations as compared to the pretreatment observations. In no case did rifampin have to be discontinued for intolerance or toxic symptoms.

The two rifampin combined regimens, given orally once weekly, proved to be well accepted, nontoxic, and highly effective, although the total weekly dose of rifampin in intermittent therapy was less than half of the weekly dose when given in daily treatment.