Rifaximin Is Effective for the Treatment ofClostridium difficile—Associated Diarrhea: Results of an Open-Label Pilot Study

Abstract

Objectives. This open-label trial assessed the efficacy and safety of rifaximin as first-line therapy in hospitalized patients with Clostridium difficile-associated diarrhea (CDAD). Methods. We enrolled thirteen patients who had a confirmed diagnosis of CDAD characterized by ≥3 unformed stools/day and positive C. difficile toxin assay. Those patients received rifaximin 400 mg three times daily for 10 days. Resolution of symptoms, repeat assay 10 days after treatment, and followup for recurrence were assessed. Results. Eight patients completed the study, and all reported symptom resolution during treatment. Mean time to last unformed stool was 132 h ± 42.5 h. Seven patients had no relapse by week 2 and in longer followup (median 162 days). One patient had recurrent CDAD during a repeat hospitalization. Conclusions. Rifaximin was effective and safe as first-line treatment for CDAD and did not result in recurrence in most patients.

Sepsis, the Liver and the Gut

“…All three showed a good response after 28 days of rifaximin 400mg three times daily. In another small study [133], there was only one recurrence after treatment of 8 patients with rifaximin for ten days. If severe disease does not respond to medical therapy, surgical intervention may be necessary.…”

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

“…Rifaximin treatment has demonstrated survival rates in animal models equivalent to vancomycin. Rubin et al [106] conducted an open label pilot study to assess the efficacy of rifaximin as an initial treatment option in patients without recurrent CDI. Of the 8 patients who completed the 10-d course of rifaximin 400 mg three times daily, 7 (88%) had symptom resolution with 10 d of rifaximin treatment with no relapse within 2 wk.…”

Abordaje multidisciplinario de la infección por Clostridium difficile

“…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. Además se evidenció una disminución en la tasa de recurrencias sin efectos adversos significativos 100,102 .…”