Mycobacterial infections prophylaxis

Unlabeled Uses Prophylaxis of Haemophilus influenzae type b infection treatment of atypical mycobacterial infection and serious infections caused by Staphybcoccus spe-... 

Ciprofloxacin and levofloxacin are no longer recommended for the treatment of gonococcal infection in the USA as resistance is now common. However, both drugs are effective in treating chlamydial urethritis or cervicitis. Ciprofloxacin, levofloxacin, or moxifloxacin is occasionally used for treatment of tuberculosis and atypical mycobacterial infections. These agents may be suitable for eradication of meningococci from carriers or for prophylaxis of infection in neutropenic patients. 

Rifampin, usually 600 mg/d (10 mg/kg/d) orally, must be administered with isoniazid or other antituberculous drugs to patients with active tuberculosis to prevent emergence of drug-resistant mycobacteria. In some short-course therapies, 600 mg of rifampin are given twice weekly. Rifampin 600 mg daily or twice weekly for 6 months also is effective in combination with other agents in some atypical mycobacterial infections and in leprosy. Rifampin, 600 mg daily for 4 months as a single drug, is an alternative to isoniazid prophylaxis for patients with latent tuberculosis only, who are unable to take isoniazid or who have had exposure to a case of active tuberculosis caused by an isoniazid-resistant, rifampin-susceptible strain. 

Rifabutin (t 36 h) has similar activity and adverse reactions, and is used for prophylaxis of Mycobacterium avium infection in patients with AIDS, and for treatment of tuberculous and nontuberculous mycobacterial infection in combination with other drugs. 

Rifabutin may be used in the prophylaxis of M. avium complex infections in immunocompromised patients and in the treatment, with other drugs, of pulmonary tuberculosis and non-tuberculous mycobacterial infections. 

Antibiotic prophylaxis, often with an oral fluoroquinolone, is used to prevent a variety of infections in patients undergoing organ transplantation or receiving cancer chemotherapy. Prophylaxis is recommended for primary and secondary prevention of opportunistic infections in AIDS patients whose CD4 counts are below certain thresholds (e.g., <200 cell/mm for the prevention of Pneumocystis pneumonia and <50 cells/mm for prevention of atypical mycobacterial infections). 

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