Rifaximin: a new treatment for travelers' diarrhea.
OBJECTIVE
To review the pharmacology, pharmacokinetics, clinical efficacy, adverse effects, drug interactions and precautions, and dosing recommendations of rifaximin, a new nonabsorbed antimicrobial agent for travelers' diarrhea.


METHODS
A MEDLINE search (1966-July 2004) was conducted to extract human and animal research data in the English language on rifaximin.


METHODS
Randomized, double-blind, placebo-controlled trials were reviewed and included to evaluate the efficacy of rifaximin in the treatment of travelers' diarrhea.


RESULTS
Rifaximin is approved for the treatment of travelers' diarrhea in patients > or =12 years of age with diarrhea caused by noninvasive strains of Escherichia coli. Rifaximin was superior to placebo and trimethoprim/sulfamethoxazole and equivalent to ciprofloxacin in the primary clinical endpoint of the time to the last unformed stool passed.


CONCLUSIONS
Rifaximin is a viable alternative to ciprofloxacin for the treatment of travelers' diarrhea. As rifaximin is not systemically absorbed, it offers the advantage of leading to the development of less resistance compared with systemically absorbed antibiotics, in addition to fewer systemic adverse effects and drug interactions. However, the potential for cross-resistance between rifaximin and rifampin, as well as with other classes of antibiotics, is of concern and needs to be elucidated.
Pakyz
Amy L
AL
Department of Pharmacy, Virginia Commonwealth University, Medical College of Virginia Campus, Smith Building, 410 North 12th St., PO Box 980533, Richmond, VA 23298-0533, USA. apakyz@vcu.edu
D003967:Diarrhea / Q000188:drug therapy* / Q000378:metabolism; D004311:Double-Blind Method; D006801:Humans; D009325:Nausea / Q000139:chemically induced; D012294:Rifamycins / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000078262:Rifaximin
D012294:Rifamycins; D000078262:Rifaximin