Phillips Matthew C, Wald-Dickler Noah, Loomis Katherine, Luna Brian M, Spellberg Brad
Los Angeles County + University of Southern California Medical Center, Los Angeles, California, USA.
Division of Infectious Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Open Forum Infect Dis. 2020 Oct 15;7(11):ofaa460. doi: 10.1093/ofid/ofaa460. eCollection 2020 Nov.
has among the highest rates of antibiotic resistance encountered in hospitals. New therapies are critically needed. We found that rifabutin has previously unrecognized hyperactivity against most strains of Here we review the pharmacology and adverse effects of rifabutin to inform potential oral dosing strategies in patients with infections. Rifabutin demonstrates dose-dependent increases in blood levels up to 900 mg per day, but plateaus thereafter. Furthermore, rifabutin induces its own metabolism after prolonged dosing, lowering its blood levels. Pending future development of an intravenous formulation, a rifabutin oral dose of 900-1200 mg per day for 1 week is a rational choice for adjunctive therapy of infections. This dosage maximizes AUC to drive efficacy while simultaneously minimizing toxicity. Randomized controlled trials will be needed to definitively establish the safety and efficacy of rifabutin to treat infections.
在医院中具有最高的抗生素耐药率之一。迫切需要新的治疗方法。我们发现利福布汀对大多数[此处缺失细菌名称]菌株具有以前未被认识到的高活性。在此，我们回顾利福布汀的药理学和不良反应，以为[此处缺失感染类型]感染患者的潜在口服给药策略提供参考。利福布汀每日剂量高达900毫克时，血药浓度呈剂量依赖性增加，但此后趋于平稳。此外，长期给药后利福布汀会诱导自身代谢，降低其血药浓度。在静脉制剂的未来研发之前，利福布汀口服剂量为每日900 - 1200毫克，持续1周，是[此处缺失感染类型]感染辅助治疗的合理选择。该剂量可使曲线下面积最大化以提高疗效，同时将毒性降至最低。需要进行随机对照试验来明确确定利福布汀治疗[此处缺失感染类型]感染的安全性和有效性。
