Antimicrobials
Rifampin

Rifampin

Low
Excellent
$

Dosing

General Information

  • Synergistic therapy of Gram positive organisms (e.g., prosthetic valve endocarditis, prosthetic joint infection)
  • Used in combination with other agents to achieve synergistic efficacy and to reduce development of resistance
  • Mycobacterial infections
  • Brucellosis
  • Osteomyelitis
  • Prosthetic joint infection
  • Endocarditis
  • Baseline and periodic LFTs
  • Multiple drug infections
  • Nausea, vomiting, diarrhea
  • Abnormal liver enzymes
  • Rash (Steven-Johnson syndrome)
  • Myopathy
  • Thrombocytopenia
  • Red-orange discoloration of bodily fluids (can permanently stain contact lenses)
  • Significant interactions - suggest Pharmacy consult to review prior to starting rifampin
  • Inducer of many CYP enzymes including 3A4 and 2C9
  • Anticoagulants & anticonvulsants are among those affected, but list of interacting drugs is long
  • Use with caution in patients with history of, or ongoing, excessive use of alcohol

Rifampin has excellent biofilm penetration, which helps sterilize infected foreign bodies (e.g., prosthetic joints or heart valves)

Antimicrobial class: Antimycobacterial, Rifamycin

Pregnancy category: C

Average serum half life: 3-4 hours

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapuetic

Route of elimination: Feces