A randomized, double-blind, placebo-controlled trial of rifaximin, a nonabsorbable antibiotic, in the treatment of tropical enteropathy.
A randomized, double-blind, placebo-controlled trial of rifaximin, a nonabsorbable antibiotic, in the treatment of tropical enteropathy.
复制标题
DOI：
10.1038/ajg.2009.270
复制
发表时间：
2009-09
影响因子：
9.8
通讯作者：
Manary, Mark J.
中科院分区：
文献类型：
--
作者：
Trehan, Indi;Shulman, Robert J.;Ou, Ching-Nan;Maleta, Kenneth;Manary, Mark J.
热带肠病的特征是在特定部位糖吸收试验中尿乳果糖与甘露醇（L：M）比值增加，并与肠道通透性增加和营养吸收能力降低相关。热带肠病的病因被假定为肠道细菌过度生长。本研究验证了一种不可吸收的广谱抗生素利福昔明治疗可降低马拉维农村儿童L：M比值的假设，在这些儿童中，热带肠病很常见。来自一个村庄的所有3-5岁的儿童都参加了一项随机、双盲、安慰剂对照的利福昔明治疗7天的试验。在治疗前后测量L：M比值，L：M比值的变化是主要结局。次要结果是尿蔗糖-乳果糖（SUC：L）和三氯蔗糖-乳果糖（SCL：L）比值的变化，以及尿液中回收的每种测试糖的分数的变化。共有144名儿童参加了这项研究，其中76%的儿童在入组时L：M比值升高（L：M≥0.10）。与接受安慰剂的儿童相比，接受利福昔明的儿童的L：M比率没有改善（分别为-0.01 ±0.12 vs. 0.02±0.16，P = 0.51，平均值±s.d.），两组之间乳果糖、甘露醇、三氯蔗糖或蔗糖的排泄量或SUC：L和SCL：L比值也无显著差异。利福昔明对3-5岁马拉维儿童的热带肠病没有影响，表明小肠细菌过度生长不是这种情况的重要病因。
Tropical enteropathy is characterized by an increased urinary lactulose-to-mannitol (L:M) ratio on a site-specific sugar absorption test and is associated with increased intestinal permeability and decreased nutrient absorptive capacity. The etiology of tropical enteropathy is postulated to be intestinal bacterial overgrowth. This study tested the hypothesis that treatment with a nonabsorbable, broad-spectrum antibiotic, rifaximin, reduces the L:M ratio in rural Malawian children, among whom tropical enteropathy is common. All children aged 3–5 years from one village were enrolled in a randomized, double-blind, placebo-controlled trial of treatment with rifaximin for 7 days. The L:M ratio was measured before and after treatment, and the change in the L:M ratio was the primary outcome. Secondary outcomes were changes in the urinary sucrose-to-lactulose (SUC:L) and sucralose-to-lactulose (SCL:L) ratios, as well as changes in the fractions of each test sugar recovered in the urine. A total of 144 children participated in this study, of whom 76% had an elevated L:M ratio on enrollment (L:M≥0.10). Children who received rifaximin did not show an improvement in their L:M ratio compared with those who received placebo (−0.01±0.12 vs. 0.02±0.16, respectively, P = 0.51, mean±s.d.), nor were there significant differences between the two groups in excretion of lactulose, mannitol, sucralose, or sucrose, or in the SUC:L and SCL:L ratios. Rifaximin had no effect on the tropical enteropathy of 3–5-year-old Malawian children, suggesting that small-bowel bacterial overgrowth is not an important etiological factor in this condition.
登录
查看更多内容
影响因子：
24.5
作者：
Menzies, IS;Zuckerman, MJ;Gregory, GG
通讯作者：
Gregory, GG
影响因子：
3.6
作者：
Campbell, DI;Lunn, PG;Elia, M
通讯作者：
Elia, M
影响因子：
25.7
作者：
DuPont, Herbert L.;Haake, Robert;Steffen, Robert
通讯作者：
Steffen, Robert
影响因子：
28.2
作者：
Huang, DB;DuPont, HL
通讯作者：
DuPont, HL
影响因子：
7.1
作者：
Galpin, L;Manary, MJ;Shulman, RJ
通讯作者：
Shulman, RJ