Rifaximin: a unique gastrointestinal-selective antibiotic for enteric diseases.
Rifaximin: a unique gastrointestinal-selective antibiotic for enteric diseases.
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DOI：
10.1097/mog.0b013e328333dc8d
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发表时间：
2010-01
影响因子：
2.5
通讯作者：
DuPont HL
中科院分区：
文献类型：
--
作者：
Koo HL;DuPont HL
利福昔明因其在多种胃肠道疾病中的潜在活性而受到关注。我们回顾了独特的药物性质的抗生素和发表的证据在文献中关于使用利福昔明不同的胃肠道疾病。利福昔明是一种胃肠道选择性抗生素，具有广谱抗菌活性，良好的安全性，最小的药物相互作用，对肠道微生物组的影响可以忽略不计。利福昔明目前在美国被批准用于治疗由非侵入性致泻性大肠杆菌引起的旅行者腹泻，并在其他30多个国家被批准用于治疗各种胃肠道疾病。在治疗和预防旅行者腹泻、门静脉系统性脑病、艰难梭菌感染、小肠过度生长、肠易激综合征、炎症性肠病、袋炎、结肠憩室病等方面进行了大量研究。利福昔明治疗旅行者腹泻有效，可作为无并发症旅行者腹泻的首选治疗方法。当怀疑有侵袭性旅行者腹泻病原体时，应使用替代抗生素。利福昔明作为旅行者腹泻的化学预防药物和门脉系统性脑病的治疗似乎很有希望。这种抗生素可能对其他胃肠道疾病有效，但需要更多精心设计的临床研究来证实其对这些标签外适应症的疗效。未来的研究将确定细菌耐药性的发展是否会限制利福昔明的使用。
Rifaximin is gaining attention for its potential activity in a multitude of gastrointestinal diseases. We review the unique pharmaceutical properties of this antibiotic and the published evidence in the literature regarding the use of rifaximin for different gastrointestinal disorders. Rifaximin is a gastrointestinal-selective antibiotic with a broad spectrum of antimicrobial activity, an excellent safety profile, minimal drug interactions, and negligible impact on the intestinal microbiome. Rifaximin is currently approved in the United States for the treatment of travelers’ diarrhea caused by noninvasive diarrheagenic Escherichia coli and is approved in more than 30 other countries for a variety of gastrointestinal disorders. Considerable research with this medication has been conducted for the treatment and prevention of travelers’ diarrhea, the treatment of portal systemic encephalopathy, Clostridium difficile infection, small bowel intestinal overgrowth, irritable bowel syndrome, inflammatory bowel disease, pouchitis, and colonic diverticular disease. Rifaximin is effective for the treatment of travelers’ diarrhea and can be considered as the treatment of choice for uncomplicated travelers’ diarrhea. When invasive travelers’ diarrhea pathogens are suspected, an alternative antibiotic should be administered. Rifaximin appears promising as a chemoprophylaxis for travelers’ diarrhea and as a treatment of portal systemic encephalopathy. This antibiotic may be effective for other gastrointestinal diseases, but more well-designed clinical studies are needed to confirm its efficacy for these off-label indications. Future studies will determine whether the development of significant bacterial resistance will limit rifaximin use.