Antibacterial Chemoprophylaxis in the Prevention of Traveler's Diarrhea: Evaluation of Poorly Absorbed Oral Rifaximin

• Published in: Clinical infectious diseases 2005-12, Vol.41 (Supplement-8), p.S571-S576
• Main Authors: DuPont, Herbert L., Jiang, Zhi-Dong, Okhuysen, Pablo C., Ericsson, Charles D., Javier de la Cabada, F., Ke, Shi, DuPont, Margaret W., Martinez-Sandoval, Francisco
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibacterials; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Campylobacter; Chemoprevention; Controlled Clinical Trials as Topic; Developing countries; Diarrhea; Diarrhea - prevention & control; Diseases; Drug Administration Schedule; Flora; Human bacterial diseases; Humans; Infectious diseases; Irritable bowel syndrome; LDCs; Medical sciences; Medication administration; Mexico; Pathogens; Pharmacology. Drug treatments; Placebos; Rifamycins - therapeutic use; Risk factors; Travel; Travelers; United States
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/432954

The use of antibacterial drugs was first shown to effectively reduce the occurrence of traveler' diarrhea nearly 50 years ago. The approach was not encouraged for general use by a Consensus Development Conference in 1985 because of concerns about adverse effects of the drugs and the possible development of resistance against systemically absorbed drugs. When therapy with poorly absorbed rifaximin was shown to be as effective as therapy with systemically absorbed drugs in shortening the duration of traveler' diarrhea, without the development of resistant coliform flora, the use of rifaximin for the prevention of traveler' diarrhea was studied. In the present study, rifaximin provided 72% protection against the development of diarrhea and 77% protection against active or treated diarrhea during 2 weeks of drug administration to United States students in Mexico. Rifaximin offers a potentially useful approach for preventing traveler' diarrhea. Potential areas of future study include use of the drug to prevent diarrhea due to mucosally invasive bacteria, including ciprofloxacin-resistant Campylobacter species, and to reduce the occurrence of postinfectious irritable bowel syndrome.