[CIS PIDD] [cis-pidd] antifungal prophylaxis during TB treatment of CGD

[Nacho Gonzalez]

Dear Laia,

you have, at least, two options: 1. Rifabutin instead of rifampicin.
See Pharmacotherapy. 2008 Aug;28(8):1076-80. Concomitant use of
voriconazole and rifabutin in a patient with multiple infections. Schwiesow
JN
<http://www.ncbi.nlm.nih.gov/pubmed?term=Schwiesow%20JN%5BAuthor%5D&cauthor=true&cauthor_uid=18657024>
1, Iseman MD
<http://www.ncbi.nlm.nih.gov/pubmed?term=Iseman%20MD%5BAuthor%5D&cauthor=true&cauthor_uid=18657024>
, Peloquin CA
<http://www.ncbi.nlm.nih.gov/pubmed?term=Peloquin%20CA%5BAuthor%5D&cauthor=true&cauthor_uid=18657024>
.
2. Avoid rifampicin and - while susceptibility test is pending- use 4 drugs
INH, ETA, PZA & LEVO/MOXI . Without RIF the treatment should be extended
for 12 months

Best regards,

Luis Ignacio Gonzalez-Granado
Immunodeficiencies Unit
Hematology & Oncology Unit.
Pediatrics
Hospital 12 octubre. Madrid. Spain


2014-10-05 11:45 GMT+02:00 Laia Alsina Manrique de Lara <lalsina at hsjdbcn.org
>:

> Dear colleagues,
>
> I would very much appreciate your comments in this particular case.
>
> We follow a 16 y-o AR-CGD who has developed a pulmonary TB (pending
> cultures and antibiogram) while on a trip home to Magreb. Rifampicin as
> first line treatment for TB is a strong inductor of cyt p450 and strongly
> interferes with azols metabolism. What would be your recommendation
> regarding itranocazole prophylaxis during TB treatment?
>
> Best regards,
>
> Laia Alsina, MD, PhD
>
> Allergy and Clinical Immunology Department
> Hospital Sant Joan de Déu, Barcelona
> Immunology Unit, Hospital Sant Joan de Déu-Hospital Clínic.
>
>
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