Acute renal failure and rifampicin: danger of unsuspected intermittent dosage.

1973) and possibly shock hypotension are responsible for the acute oliguria. This may be mediated by an immune reaction, for patients on an intermittent regimen have high levels of circulating antirifampicin antibody (Aquinas et al., 1972). The patient's husband confinned her history and we believed that it was authentic. She had been taking rifampicin and sodium aminosalicylate regularly for 16 months and suffered a severe reaction only after taking three intermittent doses of rifampicin. This is apparently the first report of combined hepatic and renal toxicity due to rifampicin, and it also seems to be the first report to incriminate rifampicin taken alone. There have been reports of immediate severe reactions with the first intermittent dose after a previous daily regimen (Kleinknecht et al., 1972). Fortunately both the hepatic and renal toxic effects are reversible but physicians and patients need to be aware of the hazards of intermittent rifampicin therapy, even after a period of regular therapy.