Successful Treatment with a High-dose Rifampin-containing Regimen for Pulmonary Tuberculosis with a Disputed rpoB Mutation

Mutations in the rpoB gene of Mycobacterium tuberculosis can result in resistance to rifampin. Among various mutations in the rpoB gene, some known as disputed rpoB mutations can cause low-level rifampin resistance. It has been suggested that a high-dose rifampin (20 mg/kg)-based regimen might be ef...

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Bibliographic Details
Published in:Internal Medicine 2018/11/15, Vol.57(22), pp.3281-3284
Main Authors: Jeong, Dae Hyun, Kang, Ye Won, Kim, Jin Young, Han, Ji Soo, Jo, Kyung-Wook, Shim, Tae Sun
Format: Article
Language:English
Subjects:
Antibiotics, Antitubercular - administration & dosage
Bacterial Proteins - genetics
Bacterial Proteins - metabolism
Case Report
disputed mutation
DNA-Directed RNA Polymerases - genetics
DNA-Directed RNA Polymerases - metabolism
Dose-Response Relationship, Drug
high-dose rifampin
Humans
Internal medicine
Male
Middle Aged
Mutation
Mycobacterium tuberculosis - genetics
Radiography, Thoracic
Rifampin
Rifampin - administration & dosage
rpoB gene
RpoB protein
Tuberculosis
Tuberculosis, Pulmonary - diagnosis
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - microbiology
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Summary:Mutations in the rpoB gene of Mycobacterium tuberculosis can result in resistance to rifampin. Among various mutations in the rpoB gene, some known as disputed rpoB mutations can cause low-level rifampin resistance. It has been suggested that a high-dose rifampin (20 mg/kg)-based regimen might be effective in treating tuberculosis (TB) caused by M. tuberculosis with disputed rpoB mutations exhibiting low-level resistance. We herein report the first two cases of pulmonary TB caused by M. tuberculosis with a disputed rpoB mutation (CTG511CCG) that showed successful treatment outcomes with a high-dose rifampin-based regimen.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.9571-17