Content area
Full text
Synopsis
Rifaximin (Xifaxan) is a nonabsorbed antibiotic for the treatment of adult traveler's diarrhea caused by enterotoxigenic strains of Escherichia coli. It is not effective for diarrhea with fever or blood in the stool or diarrhea caused by Campylobacter jejuni.
Safety
Rifaximin is minimally absorbed (less than 4 percent), making systemic effects unlikely. It has not been found to interact with drugs metabolized by the microsomal cytochrome P450 isoenzyme system.1 Rifaximin is contraindicated in patients who are allergic to rifampin (Rifadin) because it is structurally related to rifampin and has caused skin reactions in sensitive patients.1 Rifaximin is pregnancy category C. It has not been studied in children younger than 12 years.
Tolerability
Rifaximin is well tolerated. In clinical studies the dropout rate caused by adverse effects was 1 percent.2 Adverse effects such as headache, abdominal cramps, flatulence, constipation, nausea, and vomiting are difficult to separate from the symptoms of traveler's diarrhea.2,3
Effectiveness
A randomized controlled trial3 involving travelers to Mexico or Kenya who had acute traveler's diarrhea showed that dosages of 600 and 1,200 mg rifaximin daily were more...