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Rifampicin Body Fluid Counselling PJI — SCE Infectious Diseases MCQ

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EasyBone & Joint InfectionRifampicin Body Fluid Counselling PJISCE Infectious Diseases

A 55-year-old man develops a prosthetic knee joint infection. DAIR is performed and he is started on IV Flucloxacillin plus oral Rifampicin. After 2 weeks, he develops orange-coloured tears, urine, and sweat. He is alarmed. What reassurance should be given?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Rifampicin harmlessly discolours all body fluids orange-red — this is expected and the patient should have been warned before starting; soft contact lenses may be permanently stained

Rifampicin is an orange-red dye that discolours tears, urine, sweat, and saliva. This is completely harmless but alarming if patients are not pre-warned. Counselling BEFORE starting Rifampicin should include: (1) expect orange body fluids — this is normal, (2) soft contact lenses may be permanently stained — switch to glasses, (3) do NOT be alarmed — this is not a sign of toxicity. Failure to counsel leads to patient anxiety, non-adherence, and unnecessary healthcare utilisation.

Reference: BNF 2024 – Rifampicin; BSAC 2023 – PJI