Use of rifampin in Haemophilus influenzae type b infections
K. I. Li and E. R. Wald
Based on evidence that patients with infections due to Haemophilus
influenzae type b (HIB) remain colonized after therapy, recommendations for
chemoprophylaxis of susceptible contacts have included providing rifampin
for patients themselves. However, these recommendations have been made with
neither definitive advice concerning the timing of rifampin administration
nor any supporting data of efficacy and safety in patients. Our data
suggest that rifampin given concurrently with therapeutic antimicrobials is
as effective-89% (17/19)--as when given following therapeutic
antimicrobials-95% (18/19)--in eradicating pharyngeal HIB. Colonization of
the pharynx by HIB was also determined before and during therapy. Almost
all patients were colonized before beginning therapy; most were heavily
colonized. The density of colonization diminished rapidly during the first
15 to 20 hours of therapy. However, 28% of patients, primarily those who
had HIB diseases other than meningitis or did not receive any
chloramphenicol, still had detectable colonization after four to six days
of antimicrobial therapy.
