Rifaximin ( Xifaxan ), an oral, gastrointestinal-selective antibiotic, can be safely used to prevent attacks of travelers’ diarrhea caused by noninvasive strains of Escherichia coli.

A study, led by Herbert DuPont, director of the Center for Infectious Diseases at the University of Texas School of Public Health at Houston, evaluated nonabsorbable Rifaximin for prevention of travelers' diarrhea.

The clinical trial studied 210 U.S. students studying Spanish in Mexico during the summer of 2003.

Only 14.74 percent of those who took a daily dose of Rifaximin for two weeks suffered from diarrhea, while 53.7 percent of those who took placebos came down with the illness, which also includes nausea, vomiting and stomach pain.

Traveler's diarrhea has been treated for years by antibiotics because it is caused by bacteria found mainly in local food.

DuPont's group previously showed that Rifaximin is safe and effective therapy for the illness in studies carried out in Mexico, Peru, India and Kenya.

Laboratory analysis showed Rifaximin did not stimulate resistance in the Escherichia coli ( E. coli ) bacteria that causes the illness in Mexico, a finding consistent with earlier studies.

Unlike other antibiotics, which are absorbed and dispersed throughout the body, research has found Rifaximin lingers almost exclusively in the gastrointestinal tract, limiting its ability to stimulate resistance.

Researchers are following up with studies of the drug in Asia, where traveler's diarrhea is caused by other bacteria, such as Shigella, Salmonella and Campylobacter.
And they are following up an earlier finding that 10 percent of subjects who get traveler's diarrhea develop irritable bowel syndrome.

Source: Annals of Internal Medicine, 2005


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