Rifampicin is primarily used as an antibiotic to treat bacterial infections. It is highly effective against tuberculosis (TB) and is often combined with other medications like isoniazid and pyrazinamide for TB treatment. Additionally, it is used to treat leprosy and other infections caused by susceptible strains of bacteria, such as those affecting the respiratory tract, skin, and soft tissues.

In some cases, rifampicin is prescribed to prevent meningococcal meningitis in individuals exposed to the bacteria. It is also utilized in the treatment of prosthetic joint infections and osteomyelitis when combined with other antibiotics.

Beyond its antimicrobial uses, rifampicin is employed in the management of certain inflammatory conditions, such as pruritus in cholestatic liver disease, due to its ability to induce liver enzymes and alter bile acid metabolism.

Its role in research includes being a selective inhibitor of RNA polymerase in bacteria, making it a valuable tool in molecular biology studies. However, its use requires careful monitoring due to potential side effects, including liver toxicity and drug interactions.