A open-label study carried out by physicians at New York-Presbyterian Hospital / Weill Cornell Medical Center showed that there may be a new application for the antibiotic Rifaximin ( Xifaxan ) in treating patients who suffer from severe Crohn's disease and who have not responded to all other treatment options for the disease.

Rifaximin was FDA- approved for traveler's diarrhea.

These preliminary findings still require larger, controlled studies.
Investigators note that what makes Rifaximin a potentially ideal antibiotic treatment for Crohn's disease is that it remains primarily in the gut, has minimal side effects, and has a lower resistance than other antibiotics.

The researchers' analysis was performed on 8 patients. Both baseline and post-treatment disease activity were measured via the Harvey Bradshaw index, a simple clinical index of Crohn's disease severity.

Patients, aged 17 to 83 years, had an initial Harvey Bradshaw index ranging from 6 to 16 ( mean 10.9 ).

Following the treatment with Rifaximin ( 400 mg twice daily ), the Harvey Bradshaw index of these patients decreased significantly, range 1 to 7 ( mean 3.8 ), with a mean decrease in value of 7.1.
There was a significant improvement in the Harvey Bradshaw index, and the median time to response was 8.9 days.

The cause of Crohn's disease is unknown; however, many scientists suspect that it is an abnormal response to bacteria in the gastrointestinal tract.
It is this supposition that led researchers to analyze treatment with Rifaximin, a non-absorbed oral antibiotic that is gut-selective with broad-spectrum in vivo activity against gram-positive and gram-negative enteric organisms.

Results of the analysis suggest that Rifaximin may be a safe and effective treatment for Crohn's disease.

Researchers say that this small assessment shows promise for those afflicted with Crohn's disease, and that the role of Rifaximin in the induction and maintenance of remission of inflammatory bowel disease, as well as the optimal dosing schedule, should be explored in well-controlled, double-blinded clinical studies.

Crohn's disease is a chronic inflammatory disease of the gut.
It primarily causes ulcerations of the small and large intestines..
Men and women are equally affected.
Common symptoms of Crohn's Disease include abdominal pain, diarrhea, and weight loss.
Less common symptoms include poor appetite, fever, night sweats, rectal pain, and rectal bleeding.
The symptoms of Crohn's disease are dependent on the location, the extent, and the severity of the inflammation.

Source: Digestive Disease Week ( DDW ), 2005


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