Uveitis during treatment of disseminated Mycobacterium avium-intracellulare complex infection with the combination of rifabutin, clarithromycin and ethambutol.
Three patients with a cellular immunodeficiency were treated with rifabutin, clarithromycin and ethambutol for a disseminated infection with Mycobacterium avium-intracellulare complex (MAC). The patients developed uveitis, sometimes in combination with a transient rash, arthralgia, arthritis, jaundice and pseudojaundice. It seems likely that these reactions were caused by rifabutin, alone or together with other drugs such as clarithromycin. These adverse reactions probably depend on the dose, metabolism and excretion of the drug. Inhibition of cytochrome P450 seems to be an important mechanism.
Lowe
S H
SH
Department of Infectious Diseases, University Hospital Leiden, Netherlands.
Kroon
F P
FP
Bollemeyer
J G
JG
Stricker
B H
BH
van 't Wout
J W
JW
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000009:adverse effects* / Q000627:therapeutic use; D017291:Clarithromycin / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000009:adverse effects* / Q000627:therapeutic use; D004977:Ethambutol / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy*; D017828:Rifabutin / Q000009:adverse effects / Q000627:therapeutic use; D014605:Uveitis / Q000139:chemically induced*
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D017828:Rifabutin; D004977:Ethambutol; D017291:Clarithromycin