Rifampin reduces concentrations of trimethoprim and sulfamethoxazole in serum in human immunodeficiency virus-infected patients

To determine whether rifampin reduces concentrations of trimethoprim (TMP) and sulfamethoxazole (SMX) in serum of human immunodeficiency virus (HIV)-i nfected persons, levels of these agents were determined by high-performance liquid chromatography before and after more than 12 days of standard antit uberculosis treatment for 10 patients who had been taking one double-streng th tablet of co-trimoxazole once daily for more than 1 month. Statistically significant, 47 and 23% decreases in TMP and SMX mean areas under the conc entration-time curve from 0 to 24 h (AUC(0-24)), respectively, were observe d after administration of rifampin. N-Acetyl-SMX profiles without and with rifampin were similar. The steady-state AUC(0-24) metabolite/parent drug ra tio increased by 32% with rifampin administration. Our study shows that rif ampin reduces profiles of TMP and SMX in serum of HIV-infected patients.