Conference Coverage

Are higher rifampin doses for pulmonary TB more effective?



“This actually is the first trial that shows not only a dose response of rifampin but also an exposure response of rifampin in combination therapy,” he said. “Our study supports that even higher doses of rifampin beyond what we studied of 20 mg/kg should be studied for potential treatment shortening.” The evidence also suggests that the current 10-mg/kg dose is low and could be safely increased to a 15- or 20-mg/kg dose, he concluded.

In a media briefing following the presentation, moderator Constance Benson, MD, from the University of California San Diego, who was not involved in the study, commented that with “high-dose rifampin, I think we have a really very robust body of literature to which this study can be added, demonstrating the safety of high-dose rifampin in the context of TB treatment.”

“There are some circumstances where I think using a much higher dose than we’ve been using would be an appropriate thing to do,” she added.

Examples of patients who might benefit include patients with disseminated TB or people with more serious TB than the average case, she said.


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