Piero Sensi (b. 1920)
During a 1957 screening program for Dow-Lepetit Research Laboratories of Milan, Piero Sensi isolated a series of chemicals with antibacterial activity from a pine forest near Nice, France. He designated these compounds rifamycins, based on the English title of the highly acclaimed 1955 French jewelry-shop-heist film noir Rififi (originally titled Du rififi chez les hommes), which he loved.
The most promising of the rifamycins was designated rifampin in the United States and rifampicin internationally. A structurally complex semisynthetic derivative of naturally occurring rifamycin, it is classified as a broad-spectrum antibiotic. Among the wide range of bacteria against which rifampin is active are the slow-growing mycobacteria that cause tuberculosis (TB) and leprosy.
Tuberculosis has been in and out of the public health spotlight. For many centuries, particularly during the nineteenth, it was a major killer. With the introduction of new anti-TB drugs, including streptomycin, isoniazid, and rifampin, it appeared as though this old killer was vanquished, but resistant and more aggressive bacterial strains have emerged in recent decades. Once again, TB is considered a “global emergency.”
Rifampin’s primary therapeutic use is for the treatment of TB, for which it is one of the most effective drugs available. To slow the development of bacterial resistance, it is always used in combination with isoniazid. These drugs are given for six months for sensitive bacterial strains and for twelve to twenty-four months for resistant bacteria.
Rifampin is also the most effective drug available for the treatment of leprosy (Hansen’s disease). In combination with other anti-leprosy drugs, such as dapsone, it is administered once monthly for three months. Use of rifampin frequently causes the urine, sweat, saliva, and tears to assume a harmless red-orange discoloration. Liver toxicity is the most serious adverse effect associated with its use.
SEE ALSO Dapsone (1937), Streptomycin (1944), Isoniazid (1951), Ampicillin (1961).
This ribbon representation is of pyrazinamidase, an enzyme present in the tuberculosis bacterium. Pyrazinamide and rifampin are used in combination to treat dormant TB. To work, pyrazinamide must be activated by pyrazinamidase.