Rifaximin protects against Montezuma’s revenge
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The antibiotic rifaximin seems to be effective for preventing Traveler’s Diarrhea, not just for treating the problem, according to a new report.
Rifaximin, sold under the brand name Xifaxan (and possibly others), is not absorbed into the bloodstream so it’s useful for treating intestinal infections. It has proven to be an effective treatment for travelers’ diarrhea, and was recently approved for this purpose in the US.
However, it was unclear if the drug could prevent travelers’ diarrhea. To investigate, Dr. Herbert L. DuPont, from the University of Texas at Houston, and colleagues studied 210 adult students who were attending summer classes in Guadalajara, Mexico. Upon arrival, they were randomly assigned to take rifaximin, at one of three doses, or an inactive “placebo” for two weeks.
Nearly 54 percent of subjects treated with placebo developed Traveler’s Diarrhea compared with just 15 percent of those receiving rifaximin, the investigators report in the Annals of Internal Medicine.
All of the rifaximin doses were more effective than placebo.
Moreover, among participants who did not come down with out-and-out travelers’ diarrhea, rifaximin reduced the occurrence of mild diarrhea, intestinal cramping, and gas, the report indicates.
Although convincing, the results “do not strengthen the case for universal prophylaxis of travelers’ diarrhea,” argues Dr. Sherwood L. Gorbach, from Tufts University School of Medicine in Boston, in a related editorial. He believes that, rather than taking drugs to prevent the problem, “rapid and judicious treatment of diarrhea ... is the best recommendation for most travelers.”
SOURCE: Annals of Internal Medicine, May 17, 2005.
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