These are the antimicrobials used within MTW NHS Trust and West Kent CCG, please refer to the appropriate Antimicrobial guidelines for guidance on the choice of antimicrobial for different indications.
Rifampicin is a key component of any antituberculosis regimen. It may also be used for serious staphylococcal infections, e.g. endocarditis and also as first line in the prophylaxis for meningitis contacts. Rifampicin is an enzyme inducer and has numerous drug interactions including the contraceptive pill (see BNF and SPC).
Tuberculosis: the standard recommended regimen is:
| Initial phase: |
Concurrent use of 4 drugs: isoniazid, rifampicin, pyrazinamide, ethambutol for 2 months. Use fixed dose combination tablets as first choice. |
| Continuation phase: |
Isonaizid, rifampicin for a further 4 months. Combination preparations are the preferred option. Longer treatment is necessary for meningitis, spinal cord involvement and for resistant organisms which may also require modification of the regimen. |
Combination products are the first choice to treat tuberculosis as these reduce pill burden and aid patient compliance.
Pyridoxine should be given with isoniazid for the prophylaxis of isoniazid-induced neuropathy.
NG33: Tuberculosis, updated May 2016
