Scientists at St. Luke's Hospital (Houston, USA) suggest that rifaximin, a derivative of rifamycin, may soon become an alternative to ciprofloxacin to treat travelers' diarrhea. The results of the study were published in the December issue of Clinical Infectious Diseases.

Rifaximin is poorly absorbed from the digestive tract, which may eliminate the occurrence of systemic side effects (NLR).

New discoveries are of great importance. Due to the absence of systemic NLR, the drug can be safe for all categories of patients, including children, pregnant women and patients with kidney failure. Rifaximin may eliminate the need for fluoroquinolones to treat travelers' diarrhea, thereby reducing the risk of microorganisms developing resistance to fluoroquinolones.

Researchers evaluated the effectiveness of rifaximin for the treatment of diarrhea in 187 adult students in the United States and Mexico and in tourists from Jamaica. In a double-blind study from July 1998 to September 1999, patients were randomized into 2 groups: the first (93 people) received 400 mg rifaximin 2 times a day for 3 days, the second (94 people) received ciprofloxacin 500 mg 2 times a day for 3 days.

The time from the start of treatment to the last episode of untrained stool was almost the same in the rifaximin and ciprofloxacin groups (25.7 hours vs 25.0 hours, respectively). There was no statistically significant difference between patients in the two groups in the severity of clinical improvement during the first day of treatment (p = 0.199), treatment failure (p = 0.411) and microbiological response to treatment (p = 0.222). The incidence of adverse drug events was low in both groups.

This study showed that rifaximin is a safe and effective drug equivalent to ofloxacin in the treatment of acute travelers' diarrhea.

According to researchers, after rifaximin approval by the U.S. Food and Drug Administration (FDA), this antibacterial drug will be recommended as the drug of choice not only for travelers' diarrhea, but also for dysentery, but it requires controlled studies to assess rifaximin efficacy. The results of these studies should be obtained before approval of rifaximin by the FDA. Scientists suggest that "ciprofloxacin should be stored to treat more serious infections".