Summary
Although rifampicin is active against virtually all pathogenic bacteria, acquisition of resistance means that it cannot be used alone for treating infections. We have shown that, in combination with trimethoprim, this handicap can be overcome. Not only is the emergence of resistance prevented by the presence of trimethoprim, but antibacterial synergy is often observed. By applying certain logical guidelines, we have been able to suggest an appropriate combination of rifampicin and trimethoprim, which is now being tried in the treatment of various injections. There is no evidence that the emergence of resistant tubercle bacilli will be encouraged by the use of rifampicin in this way: on the contrary, this risk seems extremely remote.
Zusammenfassung
Obwohl Rifampicin gegen praktisch sämtliche pathogenen Bakterien wirkt, ergibt sich aus der Tatsache einer Resistenzentwicklung, daß es zur Behandlung von Infektionen nicht allein angewandt werden kann. Wir haben gezeigt, daß dieser Nachteil durch die Kombination mit Trimethoprim ausgeglichen werden kann. Nicht nur wird die Ausbildung einer Resistenz in Gegenwart von Trimethoprim, verhindert, sondern oft ist ein antibakterieller Synergismus festzustellen. Unter Einhaltung gewisser Richtlinien kamen wir zur Empfehlung einer geeigneten Kombination von Rifampicin und Trimethoprim, die zur Zeit bei der Behandlung verschiedener Infektionen erprobt wird. Es gibt keinen Hinweis, daß es durch diese Anwendungsart von Rifampicin vermehrt zum Auftreten resistenter Tuberkelbakterien kommt, dieses Risiko erscheint im Gegenteil äußerst gering.
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Brumfitt, W., Hamilton-Miller, J.M.T. The possible clinical value of rifampicin and trimethoprim in combination. Infection 6 (Suppl 1), S53–S56 (1978). https://doi.org/10.1007/BF01646066
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DOI: https://doi.org/10.1007/BF01646066