ANTIMICROBIAL ACTIVITY OF RIFABUTIN

Rifabutin is a spiro-piperidyl-rifamycin derived from rifamycin-S. It is structurally related to rifampin and shares many of its properties. Rifabutin has a broad spectrum of antimicrobial activity. It is consi derably more active than rifampin in vitro against the Mycobacterium a vium complex (MAC), Mycobacterium tuberculosis, and Mycobacterium lepr ae. It also is active against most atypical mycobacteria, including My cobacterium kansasii, but Mycobacterium chelonae is relatively resista nt. Rifabutin also is active against staphylococci, group A streptococ ci, Neisseria gonorrhoeae, Neisseria meningitidis, Haemophilus influen zae, Haemophilus ducreyi, Campylobacter jejuni, Helicobacter pylori, C hlamydia trachomatis, and Toxoplasma gondii. It has poor activity agai nst Enterobacteriaceae and Pseudomonas species. This review focuses on the antimicrobial profile of rifabutin in relation to its pharmacolog ical properties. Special emphasis is placed on its in vitro activity a gainst MAC and other mycobacteria, its efficacy in cell culture and an imal models, and its potential as a component of multidrug therapy for mycobacterial and other infectious diseases.