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Related Experiment Videos

Rifabutin-associated uveitis

A L Tseng1, S L Walmsley

  • 1Wellesley Health Center, University of Toronto, Ontario, Canada.

The Annals of Pharmacotherapy
|November 1, 1995
PubMed
Summary
This summary is machine-generated.

Rifabutin-associated uveitis is a rare, dose-related toxicity. Concurrent use of clarithromycin or fluconazole may increase this risk due to drug interactions. Prompt discontinuation of rifabutin is recommended if uveitis develops.

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Area of Science:

  • Ophthalmology
  • Pharmacology
  • Infectious Diseases

Background:

  • Rifabutin is increasingly used for Mycobacterium avium complex (MAC) infections in HIV patients.
  • Uveitis was initially considered a rare, dose-limited side effect of rifabutin.
  • Recent reports suggest uveitis may occur at lower, commonly prescribed doses.

Purpose of the Study:

  • To review rifabutin-associated uveitis.
  • To discuss the mechanism of uveitis.
  • To explore the role of drug interactions with clarithromycin and fluconazole.

Main Methods:

  • MEDLINE search (1991-1994) for rifabutin and uveitis.
  • Inclusion of relevant articles and conference abstracts.
  • Synthesis of 54 identified cases of rifabutin-associated uveitis.

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Main Results:

  • Uveitis occurred 2 weeks to over 7 months after starting rifabutin.
  • All patients with uveitis received concurrent clarithromycin and/or fluconazole.
  • Drug interactions with clarithromycin/fluconazole may inhibit rifabutin metabolism.
  • Uveitis resolved within 1-2 months after rifabutin discontinuation.

Conclusions:

  • Rifabutin is frequently prescribed for MAC infections in HIV patients.
  • Uveitis is a rare, dose-related toxicity of rifabutin.
  • Concurrent clarithromycin or fluconazole may increase the risk of uveitis due to drug interactions.
  • Patients should be monitored for uveitis symptoms, and rifabutin discontinued if it develops.