Rifaximin

Rifaximin is a semi-synthetic antibiotic, poorly absorbed from the gut. Rifaximin is active against Escherichia coli bacterial strains that cause traveler's diarrhea, preventing growth of the bacteria by preventing them from manufacturing proteins needed for their replication and survival . By suppressing growth of the bacteria, Rifaximin reduces symptoms of traveler's diarrhea.

Indications

-Traveler's diarrhea caused by E. coli -Irritable bowel syndrome with diarrhea (IBS-D) -Reduction in risk of overt hepatic encephalopathy recurrence

Dosage

The dosage of rifaximin varies based on the condition being treated: -Travelers' Diarrhea: 200 mg taken three times a day for 3 days. -Hepatic Encephalopathy: 550 mg taken twice a day. -IBS-D: 550 mg taken three times a day for 14 days, with the possibility of repeating the treatment course up to two times if symptoms recur. -SIBO: Typically, 400-550 mg taken two to three times a day for 7-14 days, depending on the severity and response.

Contra-Indications

Rifaximin is contraindicated in patients with: -Hypersensitivity to rifaximin, any of the rifamycin antimicrobial agents, or any of the components of the formulation. -Diarrhea complicated by fever or blood in the stool, due to the risk of systemic infection. -Severe hepatic impairment (Child-Pugh Class C).

Special Precautions

Special precautions should be taken in the following situations: -Use with caution in patients with moderate hepatic impairment (Child-Pugh Class B). -Monitor for signs of Clostridium difficile-associated diarrhea. -Prolonged use may lead to the development of bacterial resistance. -Not recommended for use in patients with diarrhea caused by pathogens other than E. coli, as it may not be effective.

Side Effects

Common side effects include: -Bloating -Gas -Headache -Dizziness

Drug Interactions

Rifaximin may interact with drugs that inhibit P-glycoprotein, such as cyclosporine and ketoconazole. It does not significantly interact with CYP enzymes.