title: Is rifaximin effective in maintaining remission in Crohn's disease?
abstract: BACKGROUND
  Recent studies indicate that persistent intestinal inflammation in patients with Crohn's disease (CD) might be caused by abnormal intestinal microbiota. This hypothesis may suggest a beneficial effect of antibiotics in CD therapy. So far, guidelines do not recommend antibiotics except in the treatment of complicated CD, and there are few studies on the effects of rifaximin in these patients.
  
  
  METHODS
  Between December 2011 and December 2012, we performed a blinded randomized trial in 168 patients with a previous history of moderately active CD concerning the efficacy of rifaximin. All the patients had previously achieved remission with standard therapy (prednisone/budesonide). Data from patients receiving 800 mg of rifaximin (83 patients) twice a day for 12 weeks were compared with those from patients who received placebo (83 patients). The primary endpoint was maintaining remission during the follow-up.
  
  
  RESULTS
  All the patients (100%; 83/83) on 800 mg of rifaximin were in remission after 12 weeks of treatment in comparison with 84% (70/83) of the placebo group. This significant difference was also persistent at the 24-week follow-up [78% (65/83) vs. 41% (34/83), respectively]. The last evaluation performed at 48 weeks revealed disease activity in 45% (38/83) of the patients of the rifaximin group, i.e. a significant decrease compared with the placebo group [75% (63 of 83)].
  
  
  CONCLUSIONS
  Remission previously obtained with standard treatment can be sustained in patients with moderately active CD after the administration of 800 mg of rifaximin.
authors: Institute of Gastroenterology and Hepatology, Iași, Romania.
authors: Anca Olivia
authors: AO
authors: Jigaranu
authors: Otilia
authors: O
authors: Nedelciuc
authors: Andreea
authors: A
authors: Blaj
authors: Mircea
authors: M
authors: Badea
authors: Catalina
authors: C
authors: Mihai
authors: Mircea
authors: M
authors: Diculescu
authors: Cristina
authors: C
authors: Cijevschi-Prelipcean
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D012074:Remission Induction; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010919:Placebos; D012294:Rifamycins; D002097:C-Reactive Protein; D000078262:Rifaximin