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Home / The International Journal of Tuberculosis and Lung Disease, Volume 15, Number 7

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

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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

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: 01 July 2011

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