Abstract
A large number of clinical studies using breath testing and a smaller number of studies using quantitative cultures of the upper small intestine established a link between irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO). A series of 12 studies both prospective and retrospective in design in a population of patients with SIBO without IBS showed that the non-absorbable antibiotic rifaximin can eradicate SIBO as proved through decrease of the exhaled hydrogen and methane in breath tests. The efficacy of rifaximin was superior over the comparator treatment in most of these studies. Based on these findings, short course rifaximin was tested in various concentrations in eight open-label trials in patients with IBS and proven SIBO by breath test. Similar efficacy of rifaximin was shown in SIBO eradication; this was accompanied by improvement of the global score for IBS symptoms. Finally, five doubleblind randomized clinical trials were conducted in patients with IBS; four were placebo-controlled. The larger trials were TARGET 1 and TARGET 2 studies testing rifaximin at a regimen of 550mg tid for 14 days. All trials showed a significant superiority of rifaximin over comparator for the improvement of global symptoms of IBS and bloating. Although the aforementioned results render rifaximin a revolutionary therapeutic approach for IBS, several concerns on induction of antimicrobial resistant flora remain.
Keywords: Bloating, irritable bowel syndrome, intestinal overgrowth, rifaximin.
Mini-Reviews in Medicinal Chemistry
Title:Rifaximin: The Revolutionary Antibiotic Approach for Irritable Bowel Syndrome
Volume: 16 Issue: 3
Author(s): Konstantinos Triantafyllou, Athanasios D. Sioulas and Evangelos J. Giamarellos-Bourboulis
Affiliation:
Keywords: Bloating, irritable bowel syndrome, intestinal overgrowth, rifaximin.
Abstract: A large number of clinical studies using breath testing and a smaller number of studies using quantitative cultures of the upper small intestine established a link between irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO). A series of 12 studies both prospective and retrospective in design in a population of patients with SIBO without IBS showed that the non-absorbable antibiotic rifaximin can eradicate SIBO as proved through decrease of the exhaled hydrogen and methane in breath tests. The efficacy of rifaximin was superior over the comparator treatment in most of these studies. Based on these findings, short course rifaximin was tested in various concentrations in eight open-label trials in patients with IBS and proven SIBO by breath test. Similar efficacy of rifaximin was shown in SIBO eradication; this was accompanied by improvement of the global score for IBS symptoms. Finally, five doubleblind randomized clinical trials were conducted in patients with IBS; four were placebo-controlled. The larger trials were TARGET 1 and TARGET 2 studies testing rifaximin at a regimen of 550mg tid for 14 days. All trials showed a significant superiority of rifaximin over comparator for the improvement of global symptoms of IBS and bloating. Although the aforementioned results render rifaximin a revolutionary therapeutic approach for IBS, several concerns on induction of antimicrobial resistant flora remain.
Export Options
About this article
Cite this article as:
Triantafyllou Konstantinos, Sioulas D. Athanasios and Giamarellos-Bourboulis J. Evangelos, Rifaximin: The Revolutionary Antibiotic Approach for Irritable Bowel Syndrome, Mini-Reviews in Medicinal Chemistry 2016; 16 (3) . https://dx.doi.org/10.2174/1389557515666150722105340
DOI https://dx.doi.org/10.2174/1389557515666150722105340 |
Print ISSN 1389-5575 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5607 |
Call for Papers in Thematic Issues
Bioprospecting of Natural Products as Sources of New Multitarget Therapies
According to the Convention on Biological Diversity, bioprospecting is the exploration of biodiversity and indigenous knowledge to develop commercially valuable products for pharmaceutical and other applications. Bioprospecting involves searching for useful organic compounds in plants, fungi, marine organisms, and microorganisms. Natural products traditionally constituted the primary source of more than ...read more
Computational Frontiers in Medicinal Chemistry
The thematic issue "Computational Frontiers in Medicinal Chemistry" provides a robust platform for delving into state-of-the-art computational methodologies and technologies that significantly propel advancements in medicinal chemistry. This edition seeks to amalgamate top-tier reviews spotlighting the latest trends and breakthroughs in the fusion of computational approaches, including artificial intelligence (AI) ...read more
Mitochondria as a Therapeutic Target in Metabolic Disorders
Mitochondria are the primary site of adenosine triphosphate (ATP) production in mammalian cells. Moreover, these organelles are an important source of reactive oxygen and nitrogen species in virtually any nucleated cell type. The modulation of a myriad of cellular signaling pathways depends on the mitochondrial physiology. Mitochondrial dysfunction is observed ...read more
Natural Products and Dietary Supplements in Alleviation of Metabolic, Cardiovascular, and Neurological Disorders
Metabolic disorders like diabetes, obesity, inflammation, oxidative stress, cancer etc, cardiovascular disorders like angina, myocardial infarction, congestive heart failure etc as well as neurological disorders like Alzheimer?s, Parkinson?s, Epilepsy, Depression, etc are the global burden. They covered the major segment of the diseases and disorders from which the human community ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Measurement of the Cellular Hemoglobin Concentration by Laser Scatter Method from Excessive Lipemic Sample: CASE REPORT
Combinatorial Chemistry & High Throughput Screening Chronic Kidney Disease and the Search for New Biomarkers for Early Diagnosis
Current Medicinal Chemistry Immunomodulation in Inflammatory Neuropathies: Rationale and Safety
Current Drug Safety The Role of Orexin System in Antipsychotics Induced Weight Gain
Current Psychiatry Reviews Design, Synthesis and Biological Evaluation of Antipicornaviral Pyrrole-Containing Peptidomimetics
Protein & Peptide Letters Role of CYP2E1 in Mitochondrial Dysfunction and Hepatic Injury by Alcohol and Non-Alcoholic Substances
Current Molecular Pharmacology Recent Advances in Immune Modulation
Current Gene Therapy Renal Development: A Complex Process Dependent on Inductive Interaction
Current Pediatric Reviews Lipodystrophy, Insulin Resistance, and Adiponectin Concentration in HIV-Infected Children and Adolescents
Current HIV Research The Synergistic Use of Computation, Chemistry and Biology to Discover Novel Peptide-Based Drugs: The Time is Right
Current Pharmaceutical Design Transcriptional Regulation of Glucose Sensors in Pancreatic β Cells and Liver
Current Diabetes Reviews Pernicious Anemia: Fundamental and Practical Aspects in Diagnosis
Cardiovascular & Hematological Agents in Medicinal Chemistry Approaches for the Development of Drugs for Treatment of Obesity and Metabolic Syndrome
Current Pharmaceutical Design Vascular Disease: A New Progenitor Biology
Current Vascular Pharmacology Microcirculation of the Diabetic Foot
Current Pharmaceutical Design Evaluation of Blood Pressure Control using a New Arterial Stiffness Parameter, Cardio-ankle Vascular Index (CAVI)
Current Hypertension Reviews From Biomarkers to Cytokine-like Hormones: Uncovering New Directives for Cognitive Loss and Alzheimer’s Disease
Current Neurovascular Research Peptides, Proteins and Peptide/Protein-Polymer Conjugates as Drug Delivery System
Protein & Peptide Letters Vascular Risk Factors and Lesions of Vascular Nature in Magnetic Resonance as Predictors of Progression to Dementia in Patients with Mild Cognitive Impairment
Current Alzheimer Research Screening for Silent Coronary Artery Disease in Diabetics- or Not?
Current Diabetes Reviews