Diverticular Disease and Rifaximin: An Evidence-Based Review

Abstract

There have been considerable advances in the treatment of diverticular disease in recent years. Antibiotics are frequently used to treat symptoms and prevent complications. Rifaximin, a non-absorbable antibiotic, is a common therapeutic choice for symptomatic diverticular disease in various countries, including Italy. Because of its low systemic absorption and high concentration in stools, it is an excellent medicine for targeting the gastrointestinal tract, where it has a beneficial effect in addition to its antibacterial properties. Current evidence shows that cyclical rifaximin usage in conjunction with a high-fiber diet is safe and effective for treating symptomatic uncomplicated diverticular disease, while the cost-effectiveness of long-term treatment is unknown. The use of rifaximin to prevent recurrent diverticulitis is promising, but further studies are needed to confirm its therapeutic benefit. Unfortunately, there is no available evidence on the efficacy of rifaximin treatment for acute uncomplicated diverticulitis.

Comparison of Rifaximin Alone and With Quinolones in the Primary Prevention of Spontaneous Bacterial Peritonitis in Patients With Decompensated Chronic Liver Disease

“…Rifaximin has a very good safety profile, as demonstrated by several clinical studies and post-marketing surveillance programs. This is likely because it has very little absorption from the stomach and, as a result, has little systemic activity [20]. Flatulence and nausea were among the few gastrointestinal side effects that were recorded.…”

Assessing the environmental impact of medicines in Italy using data from the Italian Medicines Agency

“…However, it is important to note that it could be purchased in Italy for use during travels abroad. Additionally, this medicine may be overused for the treatment of certain diseases, such as diverticulitis 47 . Moderate risk was estimated for ciprofloxacin (a fluoroquinolone) and clarithromycin (a macrolide), while erythromycin, another macrolide, was estimated at low risk.…”

Introductory Chapter: Diverticular Disease and Complications

“…The association between fiber and rifaximin (400 mg/12 h) 1 week a month for a year not only reduces the associated symptoms of diverticulitis but also reduces the risk of recurrence of this disease [7].…”