Interventions for Tuberculosis Control and Elimination 2002

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�� concentrations close to the minimum inhibitory concentration were measured in caseum and cerebrospinal fluid in meningitis. The cerebrospinal fluid to plasma concentration level ratio is between 0.52 and 1.17 over 12 hours in the experimental (healthy) rabbit model. 189 In comparative studies, mean peak rifampicin concentrations in the cerebrospinal fluid of patients with tuberculous meningitis of 2.4 mg/L were 29 �� Figure 14. Pharmacokinetics of rifampicin following meals compared to fasting. Reproduced from 188 by the permission of the publisher Churchill Livingstone. Figure 15. Tissue penetration of rifampicin with tissue-to-serum ratios. 175
obtained six hours after administration of 600 mg rifampicin, while a delayed mean peak of only 0.81 mg/L was reached nine hours after drug ingestion in normal subjects. 175 The quality of rifampicin is very susceptible to the manufacturing process. The same amount on a weight basis can lead to markedly reduced bioavailability if the particle size in the manufacturing process or the excipient are changed. 190 A particularly critical issue in the manufacture of rifampicin is its crystalline structure, which might be affected during the mixing process (particularly if there is a failure to properly control temperature and the grinding process), especially in fixed-dose combination preparations. 191-193 Dosage. The recommended dosage of rifampicin is 10 mg/kg body weight in daily treatment. 13 The recommended dosage in thrice-weekly treatment is the same as the daily dosage, because an increased frequency of a flulike syndrome has been observed with intermittent treatment at higher dosages. 194 Adverse drug events (table 3). Serum bilirubin levels increase above normal values with the usual dosage of rifampicin on the first day of treatment, but normalize within two weeks (figure 16). 195,196 The most frequent hepatic abnormality caused by rifampicin is cholestasis. Rifampicin induces isoniazid hydrolase, leading to increased formation of hydrazine, a finding that could explain the increased hepatotoxicity observed in patients receiving both rifampicin and isoniazid (figure 17). 124,197,198 Hepatitis as a result of combination therapy with rifampicin and isoniazid is the most important adverse drug event in adults 120,194,199,200 and occurs also in children, albeit less frequently. 109,201-203 Patients with HIV infection appear to be at particularly high risk of hepatotoxicity. 204-206 Whether hepatitis B HBsAg carriers are at increased risk appears to be equivocal. 207,208 In contrast, hepatitis C carriers appear to be at greatly increased risk of drug-induced hepatitis. 206 Rifampicin has been reported to cause acute interstitial nephritis 209 and glomerulonephritis. 210 Hypersensitivity reactions are infrequent or rare, and include pruritus, 211 and rarely severe muco-cutaneous toxicity, such as toxic epidermal necrolysis, 212-214 particularly in HIV-infected patients. 215,216 Rifampicin may cause menstrual disturbances such as oligomenorrhea and amenorrhea. 217 Anaphylactic shock has been reported among HIVinfected patients. 218,219 30
Page 1 and 2: Tuberculosis Interventions Interven
Page 3 and 4: Editor International Union Against
Page 5 and 6: Isoniazid plus rifampicin plus pyra
Page 7 and 8: 4. Preventive chemotherapy . . . .
Page 10: Acknowledgments It would not have b
Page 13 and 14: This monograph deals with the fourt
Page 15 and 16: ��
Page 17 and 18: ��
Page 19 and 20: contraceptives and anti-retroviral
Page 21 and 22: is scant. However, the limited evid
Page 24 and 25: 1. Chemotherapy The primary interve
Page 26 and 27: ability of the drug in the serum of
Page 28 and 29: emain elusive, 47 the general mecha
Page 30 and 31: ��
Page 32 and 33: Idiosyncratic reactions from isonia
Page 34 and 35: tis risk per 1,000 subjects was zer
Page 36 and 37: ��
Page 40 and 41: ��
Page 42 and 43: Rifampicin may rarely cause pseudom
Page 44 and 45: • opioids; 292-294 • vitamin K
Page 46 and 47: Table 4. Summary of adverse reactio
Page 48 and 49: ��
Page 50 and 51: Effect of drug potentiated by etham
Page 52 and 53: orne out by experiments which have
Page 54 and 55: longed respiratory depression follo
Page 56 and 57: quent adverse drug events are gastr
Page 58 and 59: ��
Page 60 and 61: Table 9. Grading of activities of a
Page 62 and 63: ��
Page 64 and 65: Effective or functional monotherapy
Page 66 and 67: ��
Page 68 and 69: drugs with a high therapeutic margi
Page 70 and 71: Council 122 or the individual trial
Page 72 and 73: article. The experiences in Edinbur
Page 74 and 75: Per cent positive 100 80 60 40 20 0
Page 76 and 77: Based on evidence that the addition
Page 78 and 79: esented a major advance in research
Page 80 and 81: cipal consideration is the prevaili
Page 82 and 83: of six months’ duration with ison
Page 84 and 85: Treatment efficacy As enteropathy i
Page 86 and 87: Influence of isoniazid resistance o
Page 88 and 89:
• Patients with sputum smear-posi
Page 90 and 91:
medications were taken daily throug
Page 92 and 93:
of the disease, as alternative drug
Page 94 and 95:
Number of cases per 100,000 populat
Page 96 and 97:
number of cases, the health care pr
Page 98 and 99:
necessary). If the event occurs in
Page 100 and 101:
The patient with acute renal toxici
Page 102:
and no association with diarrhea. 5
Page 105 and 106:
Schools Contacts of new cases Conta
Page 107 and 108:
too small to allow a meaningful int
Page 109 and 110:
Cases per 1,000 140 120 100 80 60 4
Page 111 and 112:
Pasteur, 1921 Moreau, 1924 Tokyo, 1
Page 113 and 114:
mendation by WHO states that no pri
Page 115 and 116:
the number of person-years of obser
Page 117 and 118:
• protection afforded by vaccinat
Page 119 and 120:
Saskatchewan Saskatchewan Chicago C
Page 121 and 122:
Three retrospective studies among c
Page 123 and 124:
Harm / protection (%) 20 0 -20 -40
Page 125 and 126:
• Differences in virulence of M.
Page 127 and 128:
infected persons may thus mask any
Page 129 and 130:
If environmental mycobacteria do in
Page 131 and 132:
Relative risk (log scale) 10 3 1 0.
Page 133 and 134:
Because BCG vaccination is given ea
Page 135 and 136:
the largest purchaser in the world)
Page 137 and 138:
made here to provide a comprehensiv
Page 139 and 140:
year following commencement of trea
Page 141 and 142:
might be expected, therefore, that
Page 143 and 144:
tionally considered to belong to gr
Page 145 and 146:
Prevention of disease following ces
Page 147 and 148:
��
Page 149 and 150:
��
Page 151 and 152:
� ��
Page 153 and 154:
Table 11. Preventive therapy - effe
Page 155 and 156:
Logistical problems may, however, i
Page 157 and 158:
In an uncontrolled study in Zambia,
Page 159 and 160:
In none of the nine prospective tri
Page 161 and 162:
is not usually an option, this is t
Page 163 and 164:
Like other aminoglycosides, amikaci
Page 165 and 166:
twice rather than once per day, red
Page 167 and 168:
Quinolones Quinolones have a potent
Page 169 and 170:
Rifapentine Rifapentine (cyclopenty
Page 171 and 172:
published a scientific blueprint fo
Page 173 and 174:
to that of isoniazid. 1162 It appea
Page 176 and 177:
Appendix 3 Current vaccine developm
Page 178:
this type of vaccine may not only p
Page 181 and 182:
15. Goldman AL, Braman SS. Chest 19
Page 183 and 184:
44. Heym B, Alzari PM, Honoré N, C
Page 185 and 186:
76. McCurdy PR, Donohoe RF. Pyridox
Page 187 and 188:
112. Van den Brande P, van Steenber
Page 189 and 190:
147. Murray FJ. Outbreak of unexpec
Page 191 and 192:
183. Acocella G, Conti R, Luisetti
Page 193 and 194:
215. Prazuck T, Fisch A, Simonnet F
Page 195 and 196:
248. Powell-Jackson PR, Jamieson AP
Page 197 and 198:
281. LeBel M, Masson E, Guilbert E,
Page 199 and 200:
310. Yeager RL, Munroe WGC, Dessau
Page 201 and 202:
341. Crowle AJ, Sbarbaro JA, Judson
Page 203 and 204:
376. Graham SM, Daley HM, Salanipon
Page 205 and 206:
410. Paradelis AG, Triantaphyllidis
Page 207 and 208:
443. Nunn P, Kibuga D, Gathua S, Br
Page 209 and 210:
471. Mitchison DA. Basic mechanisms
Page 211 and 212:
501. East African / British Medical
Page 213 and 214:
526. East African / British Medical
Page 215 and 216:
554. Medical Research Council. Five
Page 217 and 218:
580. Nolan CM. Failure of therapy f
Page 219 and 220:
606. Crofton J, Chaulet P, Maher D,
Page 221 and 222:
631. Weis SE, Slocum PC, Blais FX,
Page 223 and 224:
662. Griffith AS. A study of the BC
Page 225 and 226:
695. Horwitz O, Meyer J. The safety
Page 227 and 228:
723. World Health Organization. Rec
Page 229 and 230:
756. Al-Kassimi FA, Al-Hajjaj MS, A
Page 231 and 232:
785. Comstock GW, Webster RG. Tuber
Page 233 and 234:
814. Vynnycky E, Fine PEM. The annu
Page 235 and 236:
843. Talic RF, Hargreve TB, Bishop
Page 237 and 238:
871. Pamra SP, Mathur GP. Effects o
Page 239 and 240:
897. American Thoracic Society, Cen
Page 241 and 242:
924. Elliott AM, Halwiindi B, Bagsh
Page 243 and 244:
957. Escobar JA, Belsey MA, Dueñas
Page 245 and 246:
989. Hoffner SE, Källenius G. Susc
Page 247 and 248:
1021. Helmy B. 220-5. Side effects
Page 249 and 250:
1053. Thomas L, Naumann P, Crea A.
Page 251 and 252:
1083. Perumal VK, Gangadharam PRJ,
Page 253 and 254:
1109. Lucchesi M. L’éthionamide
Page 255 and 256:
1141. Ashtekar DR, Costa-Perira R,
Page 257 and 258:
1165. Oleksijew A, Meulbroek J, Ewi
Page 259 and 260:
1193. Hondalus MK, Bardarov S, Russ
Page 262:
IMPRESSION, BROCHAGE IMPRIMERIE CHI
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