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Rifaximin: a unique gastrointestinal-selective antibiotic for enteric diseases
Open accessAbstract
PURPOSE OF REVIEW: Rifaximin is gaining attention for its potential activity in a multitude of gastrointestinal diseases. We review the unique pharmaceutical properties of this antibiotic and the published evidence in the literature regarding the use of rifaximin for different gastrointestinal disorders. RECENT FINDINGS: Rifaximin is a gastrointestinal-selective antibiotic with a broad spectrum of antimicrobial activity, an excellent safety profile, minimal drug interactions, and negligible impact on the intestinal microbiome. Rifaximin is currently approved in the United States for the treatment of travelers' diarrhea caused by noninvasive diarrheagenic Escherichia coli and is approved in more than 30 other countries for a variety of gastrointestinal disorders. Considerable research with this medication has been conducted for the treatment and prevention of travelers' diarrhea, the treatment of portal systemic encephalopathy, Clostridium difficile infection, small bowel intestinal overgrowth, irritable bowel syndrome, inflammatory bowel disease, pouchitis, and colonic diverticular disease. SUMMARY: Rifaximin is effective for the treatment of travelers' diarrhea and can be considered as the treatment of choice for uncomplicated travelers' diarrhea. When invasive travelers' diarrhea pathogens are suspected, an alternative antibiotic should be administered. Rifaximin appears promising as a chemoprophylaxis for travelers' diarrhea and as a treatment of portal systemic encephalopathy. This antibiotic may be effective for other gastrointestinal diseases, but more well designed clinical studies are needed to confirm its efficacy for these off-label indications. Future studies will determine whether the development of significant bacterial resistance will limit rifaximin use.
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“Rifaximin is a nonabsorbable antibiotic with broad-spectrum antimicrobial activity and an excellent safety profile113 that was initially approved for the treatment of traveller’s diarrhoea but is increasingly used for the prevention of hepatic encephalopathy99.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [113]
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Metadata
- Authors
- Koo, H. L., & DuPont, H. L.
- Affiliations
- Baylor College of Medicine (US)
- Baylor St. Luke's Medical Center (US)
- Corresponding author
- Koo, Hoonmo L
- ORCID
- DuPont, Herbert L
- Venue
- Current Opinion in Gastroenterology
- Published
- 2010-01
- Volume
- 26
- Issue
- 1
- Pages
- 17-25
- ISSN
- 0267-1379 (ISSN-L)
- PMC
- PMC4737517
- OpenAlex
- W2121076704
- Cited by
- 189
- References
- 76
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 13 · 2023: 8 · 2022: 15 · 2021: 13 · 2020: 11 · 2019: 9 · 2018: 10 · 2017: 7 · 2016: 10 · 2015: 12 · 2014: 11 · 2013: 10 · 2012: 18
- FWCI
- 2.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Houston
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK084513)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
- Keywords
- rifaximin, traveler's diarrhea, portal-systemic encephalopathy, Clostridium difficile infection, small intestinal bacterial overgrowth, irritable bowel syndrome, inflammatory bowel disease, pouchitis, colonic diverticular disease, chemoprophylaxis, gut microbiota, drug resistance
- MeSH terms
- Rifaximin, Anti-Infective Agents, Bacterial Infections, Dose-Response Relationship, Drug, Drug Administration Schedule, Dysentery, Female, Follow-Up Studies, Gastroenteritis, Humans, Male, Rifamycins, Travel, Randomized Controlled Trials as Topic, Treatment Outcome, Risk Assessment
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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