Eperience with oral rifampicin in respiratory act infecti, arlet fever and bacillary dysentery

Abstract

Eleven adults with respiratory tract infections, sixteen infants with scarlet fever and twenty-seven patients with bacillary dysentery were treated with Rifampicin (RF) in a study to evaluate clinical effectiveness of the drug, with the results which may be summarized as follows1) The treatment was effective in 7 of the 11 cases of respiratory tract infections (pneumonia, bronchitis and angina follicularis) and failed to produce any significant symptomatic amelioration in 4 cases, indicating the medication to be not particularly superior to the conventional chemotherapeutic agents in these categories of diseases.2) Of the 16 infants with scarlet fever admitted to the present study, 14 eventually provided adequate clinical data for clinical evaluation. Ten of the 14 responded with significant clinical improvement, and the treatment was ineffective in the remaining 4 patients. In comparison with the clinical response in previously experienced cases of the same condition treated similarly but with several other antibiotics, the response of the children to the Rifampicin therapy was found to be less clinically beneficial than intramuscular penicillin therapy, to be practically comparable in efficacy to Clindamycin administration and to be more effective than treatment with Bicillin, EM, TC, or Spiramycin.3) Significant clinical benefit from the use of Rifampicin was evident in 7 of the adults with bacillary dysentery and in 17 of the 19 children with the same disease. The results stress chinical effectiveness of Rifampicin in this disease state for therapy with no concomitant medications. Those, however, who had failed to display complete arrest of bacillary excretion in the feces following institution of the drug continued to excrete the organism. This was the finding rather characteristic of the response to Rifampcin therapy. There was one infantile case among the 19 studied, in which laboratory and clinical data suggested emergence of drug resistance in the population of the pathogen involved. Detailed accounts are given with respect to the clinical course of this patient.4) Growing decrease in clinical efficacy in bacillary dysentery of colimycin which has seen practically no increase in incidence of resistant strains in vitro is pointed out. Further evaluation of Rifampcin therapy, in this context, as to dosage, duration and advisable concomitant chemotherapy especially with drugs not readily absorbed from the gastrointcstinal tract rcmains to be pursued.