title: Rifaximin  for the treatment of irritable bowel syndrome.
abstract: BACKGROUND
  Few therapeutic options are available for irritable bowel syndrome (IBS). Lubiprostone is approved by the FDA for IBS with constipation, and alosetron in IBS with diarrhea (IBS-D). It has been proposed that alterations in the bowel microflora may play a role in the pathophysiology of IBS, and that modulation of the microflora holds therapeutic potential. Rifaximin is a nonsystemic antibiotic that has shown efficacy in IBS.
  
  
  METHODS
  This narrative review covers the treatment options available for IBS-D and focuses on rifaximin. Rifaximin pharmacodynamics, clinical pharmacology and results of clinical studies from proof of concept to the latest Phase III and retreatment studies in IBS are summarized. Challenges to rifaximin use, safety issues and regulatory data are also discussed.
  
  
  CONCLUSIONS
  The evidence supports rifaximin as an emerging treatment for IBS. Strategies for appropriate patient selection need to be further developed, and continued efficacy of rifaximin over repeated treatment courses needs to be better characterized.
authors.affiliation: Harvard Medical School, Center for Clinical and Translational research in Gastrointestinal Motility, Beth Israel Deaconess Medical Center, Division of Gastroenterology , 330 Brookline Avenue, Boston, MA 02215, USA. fcremoni@bidmc.harvard.edu
authors.forename: Filippo
authors.initials: F
authors.lastname: Cremonini
authors.forename: Anthony
authors.initials: A
authors.lastname: Lembo
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000382:microbiology; D018579:Patient Selection; D012294:Rifamycins / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000078262:Rifaximin; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005765:Gastrointestinal Agents; D012294:Rifamycins; D000078262:Rifaximin