Rifaximin for the treatment of irritable bowel syndrome – a drug safety evaluation

  title={Rifaximin for the treatment of irritable bowel syndrome – a drug safety evaluation},
  author={Francesca Romana Ponziani and Silvia Pecere and Loris Riccardo Lopetuso and Franco Scaldaferri and Giovanni Cammarota and Antonio Gasbarrini},
  journal={Expert Opinion on Drug Safety},
  pages={983 - 991}
ABSTRACT Introduction: Irritable bowel syndrome is a functional gastrointestinal disorder with a multifactorial etiology. Alterations of intestinal motility and immunity, gut-brain interactions, as well as gut microbiota dysbiosis contribute to the development of irritable bowel syndrome. Therefore, gut microbiota modulation by non-absorbable antibiotics is a therapeutic option in patients with IBS. Areas covered: Published articles including patients with irritable bowel syndrome reporting… 
Rifaximin Re-treatment in Patients with Irritable Bowel Syndrome: Feels Like the First Time?
The TARGET-3 has demonstrated that re-treatment is effective in IBS patients who initially respond to rifaximin and experience relapsing symptoms, which is a crucial issue when an antibiotic is used in clinical practice, as the development of mechanisms of resistance among bacteria may affect clinical efficacy.
Current and emerging pharmacological approaches for treating diarrhea-predominant irritable bowel syndrome
Clinical trial data applicable to the current FDA approved IBS-D therapies as well as review data related to new and emerging therapies for this condition are discussed.
Dietary geraniol ameliorates intestinal dysbiosis and relieves symptoms in irritable bowel syndrome patients: a pilot study
The results show that orally administered Ge-OH is a powerful modulator of the intestinal microbial ecosystem, capable of leading to increased relative abundances of Collinsella and especially Faecalibacterium, a well-known health-promoting butyrate producer consistently found to be decreased in IBS patients.
Eubiotic properties of rifaximin: Disruption of the traditional concepts in gut microbiota modulation
An increase in Bifidobacterium, Faecalibacterium prausnitzii and Lactobacillus abundance after rifaximin treatment is demonstrated, probably consequent to the induction of bacterial resistance, with no major change in the overall gut microbiota composition.
New concepts on intestinal microbiota and the role of the non-absorbable antibiotics with special reference to rifaximin in digestive diseases.
Diagnosis and treatment of gastrointestinal dysfunction in hereditary TTR amyloidosis
Gastroenterologists play a valuable role in both the diagnosis and the timely management of gastrointestinal symptoms in hereditary transthyretin amyloidosis and should, therefore, be part of a multidisciplinary and comprehensive approach to this disorder.
Colonic diverticular disease
The epidemiology, pathophysiology, diagnosis and management of diverticular disease, characterized by sac-like protrusions on the wall of the large intestine, is one of the most common conditions detected on colonoscopy in the adult population.
Antibiotic Use and Microbiota
A review of antibiotics or antibiotic combinations in relation to changes in the microbiota composition and their molecular agents (genes, proteins, and metabolites), primarily the bowel is presented.
Therapeutische Modulation der Darmmikrobiota beim Reizdarmsyndrom
An overview of four current options for the treatment of irritable bowel syndrome, which are characterized by modulation of intestinal microbiota, is given and the antibiotic rifaximin is effective in selected patients.
Antibiotic use and microbiome function


The Effect of a Nonabsorbed Oral Antibiotic (Rifaximin) on the Symptoms of the Irritable Bowel Syndrome
Whether the nonabsorbed antibiotic rifaximin is more effective than placebo in reducing symptoms in adults with IBS is determined.
Rifaximin therapy for patients with irritable bowel syndrome without constipation.
Among patients who had IBS without constipation, treatment with rifaximin for 2 weeks provided significant relief of IBS symptoms, bloating, abdominal pain, and loose or watery stools.
Rifaximin treatment for small intestinal bacterial overgrowth in children with irritable bowel syndrome.
Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms: experience with Rifaximin.
SIBO should be always suspected in patients with IBS, and a differential diagnosis is done by means of a "breath test", and Rifaximin may represent a valid approach to the treatment of SIBO.
Antibiotic Treatment of Constipation-Predominant Irritable Bowel Syndrome
Rifaximin plus neomycin is superior to neomyin alone in improving multiple C-IBS symptoms and this effect is predicted by a reduction in breath methane.
Small intestine bacterial overgrowth in irritable bowel syndrome: a retrospective study with rifaximin.
Data indicate a SIBO syndrome is present in about half of patients with an IBS diagnosis and, therefore, it should always be suspected in these patients and the use of broad-spectrum non absorbable antibiotics, such as rifaximin, represents a safe and effective approach to SIBO with a low risk of causing microbial resistance.
Results of small intestinal bacterial overgrowth testing in irritable bowel syndrome patients: clinical profiles and effects of antibiotic trial.
SIBO was present in nearly half of this large cohort of IBS patients and chronic PPI use was not associated with SIBO, and Methane formers on the GBT are more likely to be constipated; Rifaximin is effective in treatment of SIBO in IBS and controlled trials are warranted.
Modulation of the gut microbiota composition by rifaximin in non-constipated irritable bowel syndrome patients: a molecular approach
Rifaximin treatment, although effective on IBS symptom relief and normalization of lactulose breath test, did not induce dramatic shifts in the microbiota composition of the subjects, stimulating microbial reorganization in some populations toward a more diverse composition.
Intestinal microecology and quality of life in irritable bowel syndrome patients.
There are intestinal flora disorders in IBS patients, which may be involved in triggering the IBS-like symptoms, and there was no significant correlation between quality of life and enteric symptoms in Ibs patients.
High-dose rifaximin treatment alleviates global symptoms of irritable bowel syndrome
  • J. Jolley
  • Medicine
    Clinical and experimental gastroenterology
  • 2011
Rifaximin 1200 mg/day for 10 days reduced gastrointestinal symptoms in patients with IBS and was well tolerated, and patients with incomplete symptom resolution may respond to increased doses of rifaxIMin.