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

• Published in: Internal Medicine Vol. 57; no. 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: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.11.2018; Japan Science and Technology Agency
• 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; disputed mutation; high-dose rifampin; rpoB gene; tuberculosis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.9571-17

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.