Dose-ranging comparison of rifampin and rifapentine in two pathologically distinct murine models of tuberculosis

Antimicrob Agents Chemother. 2012 Aug;56(8):4331-40. doi: 10.1128/AAC.00912-12. Epub 2012 Jun 4.

Abstract

In previous experiments, replacing the 10-mg/kg of body weight daily dose of rifampin with 7.5 to 10 mg/kg of rifapentine in combinations containing isoniazid and pyrazinamide reduced the duration of treatment needed to cure tuberculosis in BALB/c mice by approximately 50% due to rifapentine's more potent activity and greater drug exposures obtained. In the present study, we performed dose-ranging comparisons of the bactericidal and sterilizing activities of rifampin and rifapentine, alone and in combination with isoniazid and pyrazinamide with or without ethambutol, in BALB/c mice and in C3HeB/FeJ mice, which develop necrotic lung granulomas after infection with Mycobacterium tuberculosis. Each rifamycin demonstrated a significant increase in sterilizing activity with increasing dose. Rifapentine was roughly 4 times more potent in both mouse strains. These results reinforce the rationale for ongoing clinical trials to ascertain the highest well-tolerated doses of rifampin and rifapentine. This study also provides an important benchmark for the efficacy of the first-line regimen in C3HeB/FeJ mice, a strain in which the lung lesions observed after M. tuberculosis infection may better represent the pathology of human tuberculosis.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Antibiotics, Antitubercular / administration & dosage*
  • Antibiotics, Antitubercular / therapeutic use
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / therapeutic use
  • Disease Models, Animal
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Ethambutol / pharmacology
  • Ethambutol / therapeutic use
  • Isoniazid / pharmacology
  • Isoniazid / therapeutic use
  • Mice
  • Mice, Inbred BALB C
  • Mice, Inbred C3H
  • Microbial Sensitivity Tests
  • Mycobacterium tuberculosis / drug effects*
  • Pyrazinamide / pharmacology
  • Pyrazinamide / therapeutic use
  • Random Allocation
  • Rifampin / administration & dosage*
  • Rifampin / analogs & derivatives*
  • Rifampin / pharmacology
  • Rifampin / therapeutic use
  • Treatment Outcome
  • Tuberculosis, Pulmonary / drug therapy*
  • Tuberculosis, Pulmonary / microbiology

Substances

  • Antibiotics, Antitubercular
  • Antitubercular Agents
  • Pyrazinamide
  • Ethambutol
  • Isoniazid
  • Rifampin
  • rifapentine