Pharmacokinetic and pharmacodynamic considerations of rifamycin antibiotics for the treatment of tuberculosis

Abstract

Tuberculosis (TB) treatment was revolutionized in 1965 with the discovery of rifamycins by Sensi et al. [1]. With the introduction of rifamycins, treatment duration drastically decreased from 18 to 6 months [2]. Rifamycins, which include rifampicin, rifabutin, and rifapentine, are bactericidal DNA-dependent RNA polymerase inhibitors, that inhibit RNA synthesis of several microorganisms including Mycobacterium tuberculosis. Rifamycins contribute bactericidal activity toward the persisters, which are metabolically less active– up to now, this sterilizing activity is unparalleled.