title: Adjunctive antibiotic therapy with rifaximin may help reduce Crohn's disease activity.
abstract: OBJECTIVE
  Enteric bacteria are thought to contribute to the pathogenesis of Crohn's disease, and antibiotics may be an effective therapy. This study examines the efficacy of the nonsystemic (<0.4% absorbed) antibiotic rifaximin for inducing remission in patients with Crohn's disease.
  
  
  METHODS
  Data from charts of patients with Crohn's disease who received rifaximin between 2001 and 2005 and had a Crohn's disease activity index score > or =220 at the time of rifaximin initiation were analyzed. The use of concomitant medications (e.g., steroids, anti-inflammatory agents) was allowed.
  
  
  RESULTS
  In the 68 patient charts analyzed, the median duration of rifaximin treatment was 16.6 weeks, and the majority of patients (94%) received rifaximin 600 mg/day. Eighteen patients (26%) received rifaximin monotherapy, and 31 patients (46%) received concomitant steroids. The median baseline Crohn's disease activity index score at the time of rifaximin initiation was 265 (range, 220-460), and the mean duration of Crohn's disease was 17 years (range, 1-50 years). Crohn's disease remission occurred in 65% of patients. A 70% remission rate was achieved in patients who did not receive steroids, versus 58% in patients who received steroids. Clinical improvements continued 4 months after rifaximin initiation. Remission was achieved in 67% of patients who received rifaximin monotherapy.
  
  
  CONCLUSIONS
  Rifaximin therapy was associated with clinical improvement in patients with Crohn's disease and may be a useful treatment option to consider for inducing and maintaining remission.
authors.affiliation: Shafran Gastroenterology Center, 701 West Morse Blvd, Suite A, Winter Park, FL, 32789, USA. IRAnita@aol.com
authors.forename: Ira
authors.initials: I
authors.lastname: Shafran
authors.forename: Patricia
authors.initials: P
authors.lastname: Burgunder
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D055502:Secondary Prevention; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D012294:Rifamycins; D000078262:Rifaximin