Therapeutic Trial of Rifabutin After Rifampicin-Associated DRESS Syndrome in Tuberculosis-Human Immunodeficiency Virus Coinfected Patients

Rannakoe J Lehloenya; Sipho Dlamini; Rudzani Muloiwa; Betty Kakande; Mzudumile R Ngwanya; Gail Todd; Keertan Dheda

doi:10.1093/ofid/ofw130

Therapeutic Trial of Rifabutin After Rifampicin-Associated DRESS Syndrome in Tuberculosis-Human Immunodeficiency Virus Coinfected Patients

Open Forum Infect Dis. 2016 Jun 20;3(3):ofw130. doi: 10.1093/ofid/ofw130. eCollection 2016 Sep.

Authors

Rannakoe J Lehloenya¹, Sipho Dlamini², Rudzani Muloiwa³, Betty Kakande⁴, Mzudumile R Ngwanya⁴, Gail Todd⁴, Keertan Dheda⁵

Affiliations

¹ Division of Dermatology; Lung Infection and Immunity Unit.
² Division of Infectious Disease and HIV Medicine, Department of Medicine.
³ Department of Paediatrics and Child Health , University of Cape Town , South Africa.
⁴ Division of Dermatology.
⁵ Lung Infection and Immunity Unit.

Abstract

Elimination of a rifamycin from the treatment regimen for tuberculosis negatively impacts outcomes. Cross-reactivity between the rifamycins after drug eruptions is unclear. We report 6 consecutive human immunodeficiency virus-infected patients with rifampicin-associated drug rash with eosinophilia and systemic symptoms (DRESS) syndrome confirmed on diagnostic rechallenge. The patients subsequently tolerated rifabutin. These data inform clinical management of tuberculosis-associated drug reactions.

Keywords: alternative; rifabutin; rifampicin-associated drug eruption; tuberculosis HIV coinfection.