Interruption of Recurrent Clostridium difficile-Associated Diarrhea Episodes by Serial Therapy with Vancomycin and Rifaximin

Abstract

Eight women who each experienced 4-8 episodes of Clostridium difficile-associated diarrhea were given a 2-week course of rifaximin therapy when they were asymptomatic, immediately after completing their last course of vancomycin therapy. Seven of the 8 patients experienced no further diarrhea recurrence. The patient who had a recurrence responded to a second course of rifaximin therapy, but rifaximin-resistant C. difficile was recovered after treatment. A controlled trial for treating recurrent Clostridium difficile-associated diarrhea appears to be warranted.

Clostridium difficile-associated disease in human stem cell transplant recipients: coming epidemic or false alarm?

“…Newer approaches include long, tapered or pulsed courses of vancomycin, as well as combination or sequential dosing with either rifaximin or nitazoxanide. [1][2][3][4][5]30,[35][36][37][38][39][40][41][42][43] An algorithm outlining our own approach is shown in Figure 2.…”

High-resolution melting analysis of the single nucleotide polymorphism hot-spot region in the rpoB gene as an indicator of reduced susceptibility to rifaximin in Clostridium difficile

“…Rifaximin was reported to be a promising drug used for a follow-up therapy after vancomycin treatment for preventing recurrent CDI (Johnson et al, 2007). Thereby, the rapid detection of point mutations causing reduced rifaximin susceptibility in C. difficile strains is of high importance for the appropriate treatment of CDI and to ensure rapid therapeutic response.…”

Abordaje multidisciplinario de la infección por Clostridium difficile

“…Es un antimicrobiano no absorbible derivado de rifamicina, y que, por tanto, alcanza altas concentraciones en heces. Utilizado a dosis de 400 mg cada 8 h durante 20 días, y en combinación con la terapia estándar, parece reducir la tasa de recurrencias 100 . Se estudió su eficacia y seguridad como tratamiento inicial de la colitis por C. difficile 101 observándose una alta tasa de curación (86%), similar a las tasas de curación registradas con vancomicina y metronidazol.…”

“…Se estudió su eficacia y seguridad como tratamiento inicial de la colitis por C. difficile 101 observándose una alta tasa de curación (86%), similar a las tasas de curación registradas con vancomicina y metronidazol. Además se evidenció una disminución en la tasa de recurrencias sin efectos adversos significativos 100,102 . Como principal limitación en su uso, parece presentar una elevada tasa de desarrollo de resistencia 100 .…”