Rifampicin

Introduction

Rifampicin, also known as rifampin, is an antibiotic drug primarily used in the treatment of tuberculosis (TB). It belongs to the class of antibiotics known as rifamycins, which are derived from the bacterium Streptomyces mediterranei. Rifampicin is a bactericidal drug, meaning it kills bacteria rather than merely inhibiting their growth.

History

The discovery of rifampicin dates back to 1957 when it was isolated from Streptomyces mediterranei in the laboratory of the Italian pharmaceutical company, Lepetit. The drug was first introduced to the market in 1968 and has since been recognized as a cornerstone in the treatment of tuberculosis.

Pharmacology

Rifampicin works by inhibiting the DNA-dependent RNA polymerase of bacteria, preventing the transcription of DNA into RNA, and thereby inhibiting protein synthesis. This mechanism of action is unique to the rifamycin class of antibiotics, which includes rifampicin.

Clinical Use

Rifampicin is primarily used in the treatment of tuberculosis, often in combination with other drugs such as isoniazid, pyrazinamide, and ethambutol. It is also used in the treatment of leprosy, and certain types of meningitis.

Side Effects

While rifampicin is generally well-tolerated, it can cause a number of side effects. These include gastrointestinal disturbances, hepatotoxicity, and a unique side effect known as "red man syndrome," where the patient's urine, sweat, and tears may turn a red-orange color.

Resistance

Resistance to rifampicin is a significant concern in the treatment of tuberculosis. This resistance typically occurs through mutations in the bacterial RNA polymerase, reducing the binding affinity of rifampicin.