FOLLICULITIS
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Also, a colleague has a patient with a rifampin sensitive staph folliculitis
which recurs shortly after discontinuing the rifampin.  Because the problem is
causing a scarring alopecia, we would like to prescribe the rifampin for an
extended duration - any thoughts on the maximal length of time a patient can
safely take rifampin?

Jon Starr
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Regarding the query on rifampin and duration of therapy.  I have had leprosy
patients on the drug for extended times with appropriate monitoring, but my
understanding and practice with the drug in staph folliculitis is that the
bacteria become rapidly resistant unless you combine with another agent such as
dicloxacillin.  I have had great success with two to four week courses of diclox
500mg qid and rifampin 300 mg bid in inducing remissions in this difficult
problem. 

LJ Gregg, MD  
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I have documented repeated sterile folliculitis/furunculosis secondary to
NSAID's in my father who has Waldenstrom's macroglobulinemia, psoriasis, 
seronegative arthritis and IBD.  The neck and temples are the regions of 
distribution.  Prednisone and topical corticosteroids are the only 
control I have found for it.

Rhett Drugge, M.D.
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