Description
Rifaximin is a semi-synthetic non-systemic antibiotic based on rifamycin, which means that the drug will not pass through the gastrointestinal wall into the bloodstream, as is common with other types of orally administered antibiotics. Its use is associated with relatively few side effects and a low risk of bacterial resistance developing.
Indications
Rifaximin has a broad spectrum of activity against gram-negative and gram-positive anaerobic and aerobic bacteria. This particular antibiotic is primarily used for gastrointestinal and liver diseases as it is specific to the gastroenterological tract due to its non-absorbable profile.
Rifaximin is approved for the treatment of irritable bowel syndrome (a type of diarrhea), the treatment and prevention of hepatic encephalopathy in advanced liver disease, and the treatment of traveler’s diarrhea caused by non-invasive strains of E. coli.
Other uses include the treatment of: infectious diarrhea, bacterial overgrowth in the small intestine, inflammatory bowel disease, and diverticular disease. Rifaximin is effective in treating small intestinal bacterial overgrowth, whether or not it is associated with irritable bowel syndrome. Rifaximin has also shown efficacy in rosacea, an ocular rosacea that also manifests as dry eyes in patients with co-occurring small intestinal bacterial overgrowth.
Contraindications
Due to the excellent safety profile of rifaximin , there are very few contraindications. As with all drugs, patients who are hypersensitive to the drug, class of antibiotics, or components of the tablet should avoid this drug.
Rifaximin is given as an oral tablet that can be taken with or without food. Dosing regimens vary depending on the disease process for which the patient is being treated.
For diarrhea associated with irritable bowel syndrome (IBS-diarrhea), the recommended dose of rifaximin is 400 milligrams three times or 550 milligrams twice daily for two weeks. IBS-diarrhea may require intermittent treatment with rifaximin. Usually, for traveler’s diarrhea, 200 milligrams is given three times a day for three days. For the prevention of traveler’s diarrhea, the recommendation is to use rifaximin 200 milligrams twice daily or 600 milligrams daily during time spent in areas with a high risk of diarrhea.
Hepatic encephalopathy requires a dose of 550 milligrams twice or three times daily and is usually continued for an extended period of time to prevent recurrence. Rifaximin is usually used in combination with lactulose in the treatment of hepatic encephalopathy. For small intestinal bacterial overgrowth, the typical dose of rifaximin is 400 milligrams three times a day for two weeks. Repeated treatment may sometimes be necessary.
