Therapy of travelers' diarrhea with rifaximin on various continents.
OBJECTIVE
Our aim was to compare the efficacy and safety of rifaximin, a virtually nonabsorbed antibiotic, 600 and 1200 mg per day, with placebo in patients with travelers' diarrhea.


METHODS
This was a multicenter, 1:1:1 randomized, parallel-group, double-blind study, conducted in Antigua, Guatemala; Guadalajara and Morelia, Mexico; and the coast of Kenya north and south of Mombasa. Adult patients with acute travelers' diarrhea were recruited; exclusion criteria included primarily medication that could influence the outcome. Subjects were treated for 3 days, three times daily; follow-up lasted 5 days. For each 24-h period, the subjects completed a diary card. Pre- and posttreatment stool, blood, and urine samples were assessed.


RESULTS
Among the 380 volunteers, median time to the last unformed stool was 32.5 and 32.9 h in both rifaximin groups, compared with 60.0 h with placebo (p = 0.0001). Also, secondary clinical outcome measures were favorably influenced by the active agent. No relevant side effects were reported.


CONCLUSIONS
Rifaximin is efficacious and safe for treatment of travelers' diarrhea at daily doses of 600 mg or higher.
Steffen
Robert
R
Division of Communicable Diseases, Institute of Social and Preventive Medicine of the University, Zurich, Switzerland.
Sack
David A
DA
Riopel
Lise
L
Jiang
Zhi Dong
ZD
Stürchler
Matius
M
Ericsson
Charles D
CD
Lowe
Brett
B
Waiyaki
Peter
P
White
Mike
M
DuPont
Herbert L
HL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy; D003967:Diarrhea / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015990:Placebo Effect; D011446:Prospective Studies; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D012449:Safety; D014195:Travel; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D012294:Rifamycins; D000078262:Rifaximin