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Rifampicin monotherapy for acute guttate psoriasis-better avoided
Correspondence Address:
V Usha
TC 74/220, CRA-21, Kairali Lane, Vallakadavu, Trivandrum 695008
India
How to cite this article: Usha V, Gomathy S. Rifampicin monotherapy for acute guttate psoriasis-better avoided. Indian J Dermatol Venereol Leprol 2001;67:220 |
To the Editor,
I read with great interest, the article published by Qazi Masood et al[1] in the recent issue of the journal. Rifampicin is one of the most effective bactericidal drugs in the treatment of tuberculosis and leprosy.[2]
Streptococcal infection associated with acute guttate psoriasis is sensitive to p lactum antibiotics and other broad spectrum antibiotics.[3]
Unlike with penicillin, many organisms develop early resistance to rifampicin.[4] and in most cases it is a one step mutation.[2]
Therefore, in streptococcal infections and other infections which can be treated by β -lactum antibiotics, the use of rifampicin should be restricted, especially as a monotherapy.
Rifampicin should be reserved for tuberculosis, leprosy and other serious infections which are not responsive to the commonly used antibiotics.
Though the clinical response reported is encouraging, such studies with rifampicin as monotherapy are better avoided in the light of current resurgence of mycobacterial infections.
1. |
Qazi Masood, Manzoor S and Rukhsana A. Treatment of acute guttate psoriasis with rifampicin. Indian J Dermatol Venereol Leprol 2000; 66: 296-298.
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2. |
Lockwood DNJ and Bryceson ADM. Leprosy In: Champion RH, Burton JL. Burns DA and Breathnach SM eds. Rook/ Wilkinson/ Ebling Textbook of Dermatology. 6th ed, Blackwell Science Ltd 1998: 1215-1235.
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3. |
Bisno AL and Stevens DL. Streptococcal infections of skin and soft tissues. N Engl J Med 1996; 334: 240-245.
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4. |
Chemotherapy of tuberculosis In: Satoskar RS and Bhandarkar SD, eds. Pharmacology and Pharmacotherapeutics. 9th ed, Bombay: Popular Prakashan 1985; 590-605.
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