Pruritus associated with intravenous rifampin

OBJECTIVE: To report a probable case of moderate pruritus associated with intravenous rifampin. CASE SUMMARY: A 57-year-old woman was started on vancomycin 1 g i.v. q72h following a positive blood culture for methicillin-resistant Staphylococcus epidermidis. The patient's past medical history was significant for uterine carcinoma, radiation-induced enteritis, congestive heart failure, and renal insufficiency. Other therapy consisted of total parenteral nutrition, digoxin 0.125 mg/d i.v., and furosemide 60 mg i.v. prn for edema. Seven days later, the patient's white blood cell count increased and rifampin 600 mg/d i.v. was added to the drug regimen for potential synergy. On day 3 of rifampin therapy, the patient experienced pruritus beginning 30 minutes after the rifampin infusion ended and lasting for 6-8 hours. After 7 days of rifampin therapy, the medication was discontinued and the pruritus resolved. CONCLUSIONS: This case evaluation demonstrated probable pruritus induced by intravenous rifampin. Clinicians should be alerted that intravenous rifampin, as well as orally administered rifampin, has the potential to cause moderate pruritus.