Rifampicin endocarditis

Tablet-associated esophagitis has been reported in a 70-year-old white man on the fourth day of antibiotic therapy with vancomycin, gentamicin, and oral rifampicin for Staphylococcus epidermidis prosthetic valve endocarditis (50). 

Examples of chemoprophylaxis in the non-surgical arena include the prevention of endocarditis with amoxicillin in patients with valvular heart disease undergoing dental surgery, and the prevention of secondary cases of meningococcal meningitis with rifampicin among household contacts of an index case. 

A woman, hospitalised for endocarditis, taking digoxin 250 to 375 micrograms daily, furosemide, aspirin, isosorbide dinitrate and potassium chloride, had a marked fall of about 80% in her serum digoxin level when she was given rifampicin 600 mg daily. The serum digoxin returned to its former level over the 2 weeks following rifampicin withdrawal. She had only moderate renal impairment (serum creatinine 221 micromol/L). 

When there is neither growth in blood/tip cultures nor previously documented infection, we administer an empiric combination of different antibiotical class against the most common pathogenic agents (e.g. Moxifloxacin and Rifampicin) based on the usual antibiotic sensitivity in positive tip cultures. Blood tests are repeated at 1, 2, and 4 weeks, including inflammatory response indicators. Follow-up is necessary to document recovery from the infection and particularly regression of endocarditis lesions. 

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