Rifampicinën

Rifampicinën, commonly known as rifampicin or rifampin, is an antibiotic in the rifamycin class. It acts by inhibiting bacterial DNA-dependent RNA polymerase, blocking RNA synthesis and thereby suppressing bacterial growth. The drug is active against many Gram-positive bacteria and intracellular pathogens, and it plays a central role in treating mycobacterial infections such as tuberculosis and leprosy. It is also used for certain prophylactic indications, such as protection of contacts exposed to Neisseria meningitidis.

Therapeutic use is typically in combination with other anti-tuberculous agents to prevent resistance. In TB regimens, rifampicin is paired with isoniazid, pyrazinamide, and ethambutol. For prophylaxis, it is employed to reduce the risk of meningococcal disease following exposure and in other specific clinical scenarios. Its activity against intracellular bacteria makes it useful in some other infections, though it is not a broad-spectrum agent for all bacterial pathogens.

Pharmacokinetically, rifampicinën is well absorbed orally and is extensively metabolized in the liver. It is a potent inducer of cytochrome P450 enzymes, as well as other drug-metabolizing systems, leading to numerous drug interactions. It can cause orange-red discoloration of urine, sweat, and tears, and may stain contact lenses. Common adverse effects include hepatotoxicity, hypersensitivity reactions, gastrointestinal discomfort, and flu-like symptoms.

Contraindications include significant hepatic impairment and hypersensitivity to rifamycins. Because of interaction potential, many drugs, including oral contraceptives, antiretroviral agents, and anticoagulants, require careful monitoring or alternative therapies. Resistance develops rapidly if used alone, underscoring the importance of combination therapy in managing infections.