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. 2011 Jul;4(4):227-35.
doi: 10.1177/1756283X11398734.

Rifaximin for the treatment of acute infectious diarrhea

Kyoung Sup Hong  1 , Joo Sung Kim
Affiliations

Rifaximin for the treatment of acute infectious diarrhea

Kyoung Sup Hong et al. Therap Adv Gastroenterol. 2011 Jul.

Abstract

Rifaximin is a nonabsorbable rifamycin derivative with an excellent safety profile and a broad spectrum of antimicrobial activity against a variety of enteropathogens causing acute infectious diarrhea. After oral ingestion, its bioavailability is known to be less than 0.4%, and it has a low potential for significant drug interactions. In the treatment of travelers' diarrhea caused by noninvasive diarrheagenic Escherichia coli, it has been demonstrated that rifaximin significantly shortens the duration of diarrhea and has an efficacy similar to that of ciprofloxacin. Moreover, according to two randomized placebo-controlled trials, prophylactic treatment with rifaximin reduced the risk of developing travelers' diarrhea by more than 50% compared with the placebo group. For the treatment of acute diarrhea unrelated to travel, a short course of rifaximin significantly reduced the duration of diarrhea, and its overall efficacy was comparable to that of ciprofloxacin. The discrepancy between the in vitro and in vivoantimicrobial activities of rifaximin, however, and the clinical implication of the rapid appearance of bacterial resistance, must be further elucidated. In conclusion, this gut-selective antibiotic seems to be a promising option for the treatment of acute infectious diarrhea secondary to noninvasive E. coli and also appears to be effective in chemoprophylaxis for travelers' diarrhea.

Keywords: acute infectious diarrhea; rifaximin; travelers’ diarrhea.

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Figures

Figure 1.
Figure 1.
Chemical structure of rifaximin, highlighting the pyridoimidazole ring, which makes rifaximin nonabsorbable.
See this image and copyright information in PMC

References

    1. Berman A.L. (2007) Efficacy of rifaximin and vancomycin combination therapy in a patient with refractory Clostridium difficile-associated diarrhea. J Clin Gastroenterol 41: 932–933 - PubMed
    1. Boero M., Berti E., Morgando A. (1990) Treatment of colitis caused by Clostridium difficile: results of an open random study between rifaximin and vancomycin. Microbiol Med 5: 74–77
    1. Camilleri M., Murray J.A. Diarrhea and constipation. In: Fauci A.S., Braunwald E., Kasper D.L., Hauser S.L., Longo D.L., Jameson J.L., et al. (eds). (2008) Harrison’s Principles of Internal Medicine McGraw-Hill: New York
    1. Carter A.O., Borczyk A.A., Carlson J.A., Harvey B., Hockin J.C., Karmali M.A., et al. (1987) A Severe outbreak of Escherichia coli O157:H7-associated hemorrhagic colitis in a nursing home. N Engl J Med 317: 1496–1500 - PubMed
    1. Cho S.H., Shin H.H., Choi Y.H., Park M.S., Lee B.K. (2008) Enteric bacteria isolated from acute diarrheal patients in the Republic of Korea between the year 2004 and 2006. J Microbiol 46: 325–330 - PubMed

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