title: Enteroaggregative Escherichia coli diarrhea in travelers: response to rifaximin therapy.
abstract: OBJECTIVE
  We have recently shown that enteroaggregative Escherichia coli (EAEC) strains commonly cause travelers' diarrhea. The study was designed to determine whether U.S. travelers with EAEC diarrhea responded to rifaximin therapy.
  
  
  METHODS
  In a multicenter placebo-controlled clinical trial of travelers' diarrhea without non-EAEC pathogens we evaluated 2 doses of rifaximin. EAEC was sought in stool samples in enrolled subjects by HEp-2 cell assay. Response to rifaximin (both groups combined) and placebo were evaluated in EAEC-positive and EAEC-negative patient groups.
  
  
  RESULTS
  Compared with placebo, rifaximin shortened the postenrollment illness in travelers with EAEC diarrhea (median, 22 vs. 72 hours; P = 0.03). In subjects with EAEC-negative diarrhea, the median duration of post-treatment diarrhea was shorter with rifaximin (33 hours) than with placebo (52 hours), but this difference was not significantly different (P = 0.14).
  
  
  CONCLUSIONS
  Improvement of EAEC-mediated diarrhea with antibiotic treatment supports the pathogenicity of this organism in travelers to developing countries. The study provides information on the value of the poorly absorbed drug rifaximin in therapy of travelers' diarrhea.
authors.affiliation: Center for Infectious Diseases, The University of Texas-Houston School of Public Health and Medical School, Houston, Texas, USA.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Infante
authors.forename: Charles D
authors.initials: CD
authors.lastname: Ericsson
authors.forename: Zhi-Dong
authors.initials: ZD
authors.lastname: Jiang
authors.forename: Shi
authors.initials: S
authors.lastname: Ke
authors.forename: Robert
authors.initials: R
authors.lastname: Steffen
authors.forename: Lise
authors.initials: L
authors.lastname: Riopel
authors.forename: David A
authors.initials: DA
authors.lastname: Sack
authors.forename: Herbert L
authors.initials: HL
authors.lastname: DuPont
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003967:Diarrhea / Q000188:drug therapy* / Q000382:microbiology; D004926:Escherichia coli / Q000302:isolation & purification* / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D014195:Travel; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D012294:Rifamycins; D000078262:Rifaximin