The Effect of a Nonabsorbed Oral Antibiotic (Rifaximin) on the Symptoms of the Irritable Bowel Syndrome

  title={The Effect of a Nonabsorbed Oral Antibiotic (Rifaximin) on the Symptoms of the Irritable Bowel Syndrome},
  author={Mark Pimentel and Sandy Park and J Mirocha and Sunanda V Kane and Yuthana Kong},
  journal={Annals of Internal Medicine},
Context Few trials have evaluated the effects of antibiotics on symptoms of the irritable bowel syndrome (IBS). Contribution In this double-blind trial, 87 patients with IBS were randomly assigned to either rifaximin (400 mg 3 times daily) or placebo for 10 days. Over a 10-week follow-up period, the rifaximin recipients reported global improvements in overall symptoms and less bloating more frequently than the placebo recipients. No major differences in abdominal pain, diarrhea, or constipation… 
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 Symptoms of Irritable Bowel Syndrome
Rifaximin offers a potential new therapeutic option for patients with refractory IBS, and in some cases, correlated with reductions in hydrogen breath tests, suggesting successful treatment of bacterial overgrowth.
Efficacy of Rifaximin, a Nonabsorbed Oral Antibiotic, in the Treatment of Small Intestinal Bacterial Overgrowth
Rifaximin in a dose of 800 mg per day for 4 weeks was safe and effective treatment in reducing symptoms in patients with SIBO of multiple etiologies, especially when diarrhea was the dominant symptom and normalized the glucose breath test in approximately 50% of patients.
Non-Absorbed Antibiotic for Irritable Bowel Syndrome
  • B. Cash
  • Medicine
    Current gastroenterology reports
  • 2011
This report represents pooled data from two identical phase 3, double-blind, placebo-controlled, multicenter trials in which patients with non-constipated IBS were randomized to receive rifaximin or placebo three times a day for 2 weeks.
Profile of rifaximin and its potential in the treatment of irritable bowel syndrome
Clinical studies have demonstrated that rifaximin improves symptoms associated with IBS, such as bloating, flatulence, stool consistency, and abdominal pain, and has a side-effect profile similar to placebo, which presents as a safe and beneficial addition to the current management options for IBS.
Rifaximin for the treatment of diarrhoea-predominant irritable bowel syndrome
Rifaximin, with its low systemic absorption and no clinically significant interactions with other drugs, may represent a treatment of choice for IBS, mainly due to its ability to act on IBS pathogenesis, through the modulation of gut microbiota.
Repeat Treatment With Rifaximin Is Safe and Effective in Patients With Diarrhea-Predominant Irritable Bowel Syndrome.
In a phase 3 study of patients with relapsing symptoms of IBS-D, repeat rifaximin treatment was efficacious and well tolerated and significant improvements were noted for prevention of recurrence, durable response, and bowel movement urgency.
Rifaximin for the treatment of irritable bowel syndrome – a drug safety evaluation
Rifaximin is a non-absorbable antibiotic with additional anti-inflammatory and gut microbiota-modulating activity that is effective in inducing symptoms relief in patients with IBS, even after repeated treatment courses.
Mechanism of action and therapeutic benefit of rifaximin in patients with irritable bowel syndrome: a narrative review
Current studies indicate that rifaximin induces only modest effects on the gut microbiota of patients with IBS-D, suggesting that the efficacy of rifaxin may involve other mechanisms, and further study is needed.
Repeat Rifaximin for Irritable Bowel Syndrome: No Clinically Significant Changes in Stool Microbial Antibiotic Sensitivity
Rifaximin exposure was not associated with long-term cross-resistance of Bacteroidaceae, Enterobacteriaceae, and Enterococcaceae to rifampin or nonrifamycin antibiotics tested.


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.
A Randomized, Double-Blind, Placebo-Controlled Trial of Rifaximin To Prevent Travelers' Diarrhea
Rifaximin has been shown to be safe and effective for treatment of travelers' diarrhea in Mexico, Jamaica, Guatemala, and Kenya and the availability of an effective drug with less than 0.4% absorption offered an opportunity to reexamine the use of antibacterial drugs in the prevention of travellers' diarrhea.
Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles.
B infantis 35624 alleviates symptoms in IBS; this symptomatic response was associated with normalization of the ratio of an anti-inflammatory to a proinflammatory cytokine, suggesting an immune-modulating role for this organism, in this disorder.
Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome
An improvement in irritable bowel syndrome symptoms with diarrhea and abdominal pain being statistically significant after Bonferroni correction is revealed.
Management of Inflammatory Bowel Disease: Does Rifaximin Offer Any Promise?
Rifaximin, a rifamycin-derived antibiotic, is characterized by a wide range of antibacterial activity and a very low systemic absorption and some preliminary data show its efficacy in severe active ulcerative colitis, pouchitis and prevention of postoperative recurrence in Crohn’s disease.
A Randomized Double-Blind Placebo-Controlled Trial of Rifaximin in Patients with Abdominal Bloating and Flatulence
Rifaximin is a safe and effective treatment for abdominal bloating and flatulence, including in IBS patients, and symptom improvement correlates with reduction in H2-breath excretion.
Normalization of Lactulose Breath Testing Correlates With Symptom Improvement in Irritable Bowel Syndrome: A Double-Blind, Randomized, Placebo-Controlled Study
Normalization of LBT with neomycin leads to a significant reduction in IBS symptoms, and the type of gas seen on LBT is also associated with IBS subgroup.
Prevalence of irritable bowel syndrome: a community survey.
Quality of life was significantly reduced in patients with IBS and population-based health surveys will need to supplement the Rome criteria with questions aiming to identify patients formally diagnosed but whose symptoms are currently under control if prevalence is to be reliably estimated.