Therapy of Travelers' Diarrhea With Rifaximin on Various Continents

Abstract

Rifaximin is efficacious and safe for treatment of travelers' diarrhea at daily doses of 600 mg or higher.

Rifaximin for the treatment of acute infectious diarrhea

“…Moreover, in all four RCTs on the use of rifaximin for the treatment of travelers' diarrhea, the rates of adverse events in the rifaximin-treated patients were not different from those in the ciprofloxacin-or placebo-treated patients [Taylor et al 2006;Steffen et al 2003;Dupont et al 2001Dupont et al , 1998]. …”

“…Moreover, the participants in the rifaximin groups showed better clinical responses than the placebo group (79.2% and 81.0% vs. 60.5%, p ¼ 0.001). Nevertheless, the microbiologic-eradication rates based on the posttreatment fecal cultures in the participants with at least one pathogen before treatment were not significantly different across the treatment groups, and it was the same in the subgroup with ETEC identified from the stool specimens [Steffen et al 2003]. …”

“…Although a variety of bacterial, viral, and parasitic organisms can cause travelers' diarrhea, diarrhea-producing E. coli predominates. There have been four randomized controlled trials (RCTs) that demonstrated the efficacy of rifaximin for the treatment of travelers' diarrhea [Taylor et al 2006;Steffen et al 2003;Dupont et al 2001Dupont et al , 1998 (Table 1). The primary endpoint in these trials was the time to the last unformed stool (TLUS), defined as the time from the first dose of medication to the passage of the last unformed stool, after which the patient already feels well.…”

“…One study with three treatment arms was conducted in 380 patients at clinical sites in Mexico, Guatemala, and Kenya (study 1) [Steffen et al 2003]. The study participants were randomized to receive either 3-day courses of rifaximin (200/400 mg three times a day) or placebo.…”

“…The efficacy of rifaximin orally taken at a dose of 200 mg three times a day for 3 days, the currently recommended dose for acute diarrhea, was evaluated in two RCTs in adult patients with travelers' diarrhea [Taylor et al 2006;Steffen et al 2003]. One study with three treatment arms was conducted in 380 patients at clinical sites in Mexico, Guatemala, and Kenya (study 1) [Steffen et al 2003].…”