Rifaximin versus ciprofloxacin for the treatment of traveler's diarrhea: a randomized, double-blind clinical trial.
Rifaximin is a poorly absorbed rifamycin derivative under investigation for treatment of infectious diarrhea. Adult students from the United States in Mexico and international tourists in Jamaica were randomized to receive either rifaximin (400 mg twice per day) or ciprofloxacin (500 mg twice per day) for 3 days, following a double-blinded model, from June 1997 to September 1998. A total of 187 subjects with diarrhea were studied. Time from initiation of therapy to passage of last unformed stool was comparable for those receiving rifaximin or ciprofloxacin (median, 25.7 hours versus 25.0 hours, respectively). There was no significant difference in the proportion of subjects in the 2 groups with respect to clinical improvement during the first 24 hours (P=.199), failure to respond to treatment (P=.411), or microbiological cure (P=.222). The incidence of adverse events was low and similar in each group. Rifaximin is a safe and effective alternative to ciprofloxacin in the treatment of traveler's diarrhea.
DuPont
H L
HL
Center for Infectious Diseases, The University of Texas-Houston School of Public Health and Medical School, 77030, USA. hdupont@sleh.com
Jiang
Z D
ZD
Ericsson
C D
CD
Adachi
J A
JA
Mathewson
J J
JJ
DuPont
M W
MW
Palazzini
E
E
Riopel
L M
LM
Ashley
D
D
Martinez-Sandoval
F
F
D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use*; D003967:Diarrhea / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D004311:Double-Blind Method; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012294:Rifamycins / Q000009:adverse effects / Q000627:therapeutic use*; D000078262:Rifaximin
D000890:Anti-Infective Agents; D012294:Rifamycins; D002939:Ciprofloxacin; D000078262:Rifaximin