Management of inflammatory bowel disease: does rifaximin offer any promise?
An increasing number of both clinical and laboratory-derived observations support the importance of luminal components in driving the inflammatory response in ulcerative colitis and Crohn's disease. Although its role is unclear, antibiotic therapy is commonly used in clinical practice for the treatment of moderately to severely active ulcerative colitis. Metronidazole and/or ciprofloxacin are currently employed in active Crohn's disease, particularly in patients with colonic involvement and with perianal disease. Rifaximin, a rifamycin-derived antibiotic, is characterized by a wide range of antibacterial activity and a very low systemic absorption. Some preliminary data show its efficacy in severe active ulcerative colitis, pouchitis and prevention of postoperative recurrence in Crohn's disease.
Gionchetti
Paolo
P
IBD Unit, Department of Internal Medicine and Gastroenterology, University of Bologna, Italy. paolo@med.unibo.it
Rizzello
Fernando
F
Morselli
Claudia
C
Romagnoli
Rossella
R
Campieri
Massimo
M
D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001419:Bacteria / Q000302:isolation & purification; D002939:Ciprofloxacin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D006801:Humans; D007408:Intestinal Absorption; D007422:Intestines / Q000382:microbiology; D008795:Metronidazole / Q000627:therapeutic use; D012294:Rifamycins / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000078262:Rifaximin
D000900:Anti-Bacterial Agents; D012294:Rifamycins; D008795:Metronidazole; D002939:Ciprofloxacin; D000078262:Rifaximin