Novobiocin Rifampicin

AcrAB- TolC Tetracycline, fluoroquinolones, chloramphenicol, p-lactams except imipenem, novobiocin, erythromycin, fusidic acid, rifampicin E. coli Chromosome... 

Although novobiocin has been used alone or with other drugs, such as rifampicin or tetracycline, in the treatment of infections due to staphylococci and other susceptible organisms, it has largely been superseded by other drugs because of the problems of resistance and toxicity. 

Reports of drug-induced thrombocytopenia have been systematically reviewed (1). Among the 98 different drugs described in 561 articles the following antibiotics were found with level I (definite) evidence co-trimoxa-zole, rifampicin, vancomycin, sulfisoxazole, cefalothin, piperacillin, methicillin, novobiocin. Drugs with level II (probable) evidence were oxytetracycline and ampicillin. 

Rifampicin reduces the half-life of novobiocin but this is unlikely to be clinically signiflcant. 

When 10 healthy subjects were given novobiocin 1 g daily for 13 days with rifampicin 600 mg daily, the novobiocin half-life was reduced from 5.85 to 2.66 hours and the AUC was reduced by almost 50%. There were no significant changes to the half-life or AUC of rifampicin. The serum novobiocin and rifampicin levels were not significantly altered and the trough serum levels of both antibacterials when given alone or concurrently remained in excess of the MIC for 90% of the strains of MRSA tested. No special precautions would therefore seem to be necessary during concurrent use. 

Curing of plasmids pRGOl, pRG02 and pRG05 from the respective strains had no effect on their capacity to synthesize bacteriocin, or to ferment 21 carbohydrates, as well as on their resistance to 21 antibiotics, including ampicillin, bacitracin, cephalotin, chloramphenicol, cloxacillin, erythromycin, fusidic acid, gentamycin, kanamycin, lyncomycin, metycillin, nalidixic acid, neomycin, novobiocin, oxacycline, penicillin, rifampicin, streptomycin, tetracycline, trimethoprim, and vancomycin. 

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