Rifampin

C difficile risk
Low
Oral Bioavailability
Excellent

Dosing

Consult pharmacy for dosing for specific indication.

Infuse over 60 minutes

Age 0-4 Wk10 mg/kg/dose IV/PO Q12H

Age 0-7 DaysAge >7 Days10 mg/kg/dose IV/PO Q12H10 mg/kg/dose IV/PO Q12H

Age 0-7 DaysAge >7 Days10 mg/kg/dose IV/PO Q12H10 mg/kg/dose IV/PO Q12H

All Infants10 mg/kg/dose IV/PO Q12H

IV, PO

6 mg/mL

  1. Reconstitute 600mg vial with 10mL of sterile water for injection. Swirl via gently to completely dissolve powder. Concentration = 60 mg/mL
  2. Mix 9mL of NS with 1mL of 60 mg/mL concentration in a 10mL empty sterile vial = 6 mg/mL

60 mg/mL = 24H (after first use) 6 mg/mL = 24H (after first use) Room temperature

Neonatal: Reduce dose in liver impairment

General Information

Used in combination with other agents, not as monotherapy.

  • Mycobacterial infections including tuberculosis

  • Brucellosis

  • Staphylococcus infections, including bone and joint, primarily in the setting of retained hardware or other prosthetic material for activity against biofilm formation.

Pregnancy: Several reviews have evaluated the available treatment of tuberculosis during pregnancy. All concluded that rifampin was not a proven teratogen and recommended use of the drug if necessary. Other reports on the use of rifampin in pregnancy have observed no fetal harm.

Breastfeeding: Limited information indicates that there are low levels of rifampin in breastmilk that are likely not clinically relevant and would not be expected to cause any adverse effects in breastfed infants.

Multiple significant drug interactions. Consult pharmacy whenever a patient is started on rifampin therapy.

Baseline and every 2 to 4 weeks during therapy:

  • Liver enzymes, liver function tests

  • Scr

  • CBC Monitor coagulation tests during treatment in patients at risk of vitamin K deficiency

  • Headache, dizziness, confusion

  • GI intolerance

  • Red-orange discolouration of urine, stools, saliva, lung secretions, sweat, tears, and skin - do not wear contact lenses to avoid their permanent discoloration

  • Disorder of hemostatic components of blood (vitamin K-dependent), disseminated intravascular coagulation, eosinophilia, hemolytic anemia, hemorrhage, leukopenia, thrombocytopenia

  • Abnormal hepatic function tests, hepatic insufficiency, hyperbilirubinemia, jaundice

Multiple significant drug interactions. Consult pharmacy whenever a patient is started on rifampin therapy.

Antimicrobial class: Antitubercular agent; Inhibits bacterial RNA synthesis by binding to the beta subunit of DNA-dependent RNA polymerase, blocking RNA transcription

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