Rifampicin is a semi-synthetic broad-spectrum antibiotic very effective against mycobacteria, Brucella, and Staphylococci.
Anaphylactic shock is rare (6/30 000 reports of possible allergic reactions to rifampicin).
Flu-like syndrome: rare when administered in daily regimens (0.1 to 4%) ; frequent in intermittent or discontinuous regimens (20%).
Intermittent treatment (flu-like syndrome, acute haemolytic anemia, renal failure, thrombocytopenic purpura).
General: anaphylactic shock, serum sickness.
Cutaneous: pruritus, erythema, facial swelling, maculopapular rash, urticaria, vasculitis, Stevens-Johnson’s syndrome, red man syndrome.
Respiratory: shortness of breath, bronchospasm.
Haematological: thrombocytopenia, haemolytic anemia.
Renal: renal failure.
Intradermal skin-tests: 1/1000 to 1/10 (intravenous rifampicin 60 mg/ ml): positive in a few cases of anaphylactic shock.
Specific IgE (RAST)
Circulating rifampicin dependent antibodies, especially when intermittent therapy is used (Coombs test, complement binding test, antiglobulin test)
Circulating immune complexes.
Haemolytic complement titers
Possible IgE-mediated hypersensitivity: anaphylactic shock with immediate positive skin-tests.
Type II hypersensitivity: blood dyscrasias.
Type III hypersensitivity: serum sickness.
Desensitization (contra-indicated if severe manifestations: renal failure, thrombocytopenia).
- 0.1 mg ; 0.5 mg ; 1 mg ; 2 mg ; 4 mg ; 8 mg ; 16 mg ; 32 mg ; 50 mg: 100 mg ; 150 mg at 45 minutes intervals, then 300 mg 3H30 later, then 300 mg x 2 next day.
- 0.1 mg to 300 mg within 17 hours.