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Rev. cuba. med. mil ; 50(3): e1336, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1357306


Introducción: En la medicina militar, la aplicación de las sustancias antibacterianas en las infecciones tópicas, es importante en el tratamiento de las tropas. Objetivos: Evaluar el efecto antibacteriano sinérgico de rifamicina en propóleo sobre bacterias grampositivas. Métodos: Estudio experimental in vitro y comparativo. Se efectuó el análisis fitoquímico preliminar del propóleo de Apis mellífera. Se utilizaron 96 placas de agar Muller Hinton (Britania®) (48 placas para cada especie bacteriana) repartidas en 6 grupos (n = 8). grupo I (agua destilada), grupo II (alcohol etílico al 96 por ciento), grupo III (rifamicina al 0,5 por ciento), grupo IV (rifamicina al 1 por ciento), grupo V (propóleo al 20 por ciento) y grupo VI (rifamicina al 1 por ciento en propóleo al 40 por ciento); se empleó la metodología de Kirby - Bauer; las cepas usadas fueron Staphylococcus aureus ATCC 25923, Streptococcus pyogenes ATCC 19615 y las mediciones de las zonas de inhibición se efectuaron a las 24 horas. Resultados: Se detectaron compuestos fenólicos, taninos, flavonoides, alcaloides y triterpenoides en propóleo. Se comprobó el efecto antibacteriano del grupo V con 18,627 ± 0,1008 mm (92,59 por ciento) y 19,247 ± 0,0762 mm (96,74 por ciento), y el efecto antibacteriano sinérgico del grupo VI con 19,316 ± 0,1202 mm (96,02 por ciento) y 19,613 ± 0,0820 mm (98,58 por ciento), comparados con rifamicina al 1 por ciento (100 por ciento) sobre S. aureus ATCC 25923 y S. pyogenes ATCC 19615. Conclusiones: La combinación de rifamicina al 1 por ciento unida al propóleo al 40 por ciento presenta una mayor actividad antibacteriana in vitro sobre bacterias grampositivas debido a su efecto sinérgico(AU)

Introduction: In military medicine, the application of antibacterial substances in topical infections are important in the treatment of troops. Objectives: To evaluate the synergistic antibacterial effect of rifamycin in propolis on gram-positive bacteria. Methods: In vitro and comparative experimental study. Preliminary phytochemical analysis of Apis mellifera propolis was carried out. 96 Muller Hinton agar plates (Britania®) (48 plates for each bacterial species) divided into 6 groups (n = 8) were used group I (distilled water), group II (96 percent ethyl alcohol), group III (rifamycin 0,5 percent), group IV (rifamycin 1 percent), group V (propolis 20 percent) and group VI (rifamycin 1 percent in 40 percent propolis); Kirby-Bauer methodology was used; the strains used were Staphylococcus aureus ATCC 25923, Streptococcus pyogenes ATCC 19615 and the measurements of the zones of inhibition were carried out at 24 hours. Results: Phenolic compounds, tannins, flavonoids, alkaloids and triterpenoids were detected in propolis. The antibacterial effect of group V was verified with 18,627 ± 0,1008 mm (92,59 percent) and 19,247 ± 0,0762 mm (96,74 percent), and the synergistic antibacterial effect of group VI with 19,316 ± 0,1202 mm (96,02 percent) and 19,613 ± 0,0820 mm (98,58 percent), compared with rifamycin 1 percent (100 percent) on S. aureus ATCC 25923 y S. pyogenes ATCC 19615. Conclusions: The combination of rifamycin 1 percent together with propolis 40 percent has a greater antibacterial activity in vitro on gram-positive bacteria due to its synergistic effect(AU)

Humans , Rifamycins , Gram-Positive Bacteria , Military Medicine , In Vitro Techniques , Anti-Bacterial Agents/analysis
Mem. Inst. Oswaldo Cruz ; 114: e180420, 2019. tab
Article in English | LILACS | ID: biblio-984758


BACKGROUND Rifamycins are a group of antibiotics mainly used in the treatment of tuberculosis (TB), however they interact with antiretroviral therapy (ART). Rifabutin allows more regimens options for concomitant imunodeficiency virus (HIV) treatment compared to rifampicin. OBJECTIVE Compare the outcomes of TB-HIV co-infected patients who used rifampicin or rifabutin. METHODS We analysed data from a prospective cohort study at National Institute of Infectious Diseases Evandro Chagas, Rio de Janeiro (RJ), Brazil. Patients who were treated for TB and HIV with rifampicin or rifabutin, from February 2011 to September 2016 were included. FINDINGS There were 130 TB-HIV patients, of whom 102 were treated with rifampicin and 28 with rifabutin. All patients in the rifabutin-treated group and 55% of the rifampicin-treated group patients were ART-experienced. Patients treated with rifampicin had similar abandon and cure rates, interruptions in treatment due to adverse reactions, immune reconstitution inflammatory syndrome and a similar mortality rate as those treated with rifabutin. However, rifampicin-treated patients had higher CD4 counts and more frequently undetectable HIV viral load by the end of treatment (67% versus 18%, p < 0.001) compared to rifabutin-treated patients, even when only ART-experienced patients were evaluated (66,6% versus 36,3%, p = 0.039). CONCLUSIONS Patients who used rifabutin had worst immune and virological control. This group had more ART-experienced patients. New and simpler regimens are needed for patients who do not respond to previous antiretroviral therapies.

Humans , Rifamycins/therapeutic use , Tuberculosis/prevention & control , Outcome Assessment, Health Care , Rifabutin/therapeutic use , Rifampin , HIV
Ann. hepatol ; 16(1): 115-122, Jan.-Feb. 2017. graf
Article in English | LILACS | ID: biblio-838093


Abstract: Introduction. Minimal hepatic encephalopathy (MHE) can reverse after short-term treatment. However, relapse rate of MHE after stopping treatment has not been studied so far. We aimed to evaluate long-term (9 months) efficacy of a short-term (3 months) treatment of MHE with lactulose/rifaximin, for maintenance of remission from MHE. Material and methods. In this prospective study, consecutive patients with cirrhosis and MHE were treated with lactulose/rifaximin for 3 months. After treatment, they were followed up for 6 months. Psychometric testing for diagnosis of MHE was performed at baseline, 3 months and 9 months. Results. Of the 527 patients screened, 351 were found eligible and tested for MHE. Out of these, 112 (31.9%) patients had MHE (mean age 55.3 years; 75% males). They were randomized to receive Rifaximin (n = 57; 1,200 mg/day) or Lactulose (n = 55; 30-120 mL/day) for three months. At 3 months, 73.7% (42/57) patients in Rifaximin group experienced MHE reversal compared to 69.1% (38/55) in Lactulose group (p = 0.677). Six months after stopping treatment, 47.6% (20/42) in rifaximin group and 42.1% (16/38) patients in lactulose group experienced MHE relapse (p = 0.274). The overt hepatic encephalopathy development rate (7.1% vs. 7.9%) and mortality rate (0.23% vs. 0%) were similar in both groups. The Child-Turcotte-Pugh score and model for end stage liver disease (MELD) scores of patients who had MHE relapse were higher compared to those who didn’t. On multivariate regression analysis, MELD score was an independent predictor of MHE relapse. Conclusion. Of the patients who became MHE negative after short-term (3 months) treatment with rifaximin/lactulose, almost 50% had a relapse of MHE at 6 months follow-up.

Humans , Middle Aged , Rifamycins/administration & dosage , Hepatic Encephalopathy/drug therapy , Lactulose/administration & dosage , Liver Cirrhosis/complications , Psychometrics , Recurrence , Rifamycins/adverse effects , Time Factors , Remission Induction , Drug Administration Schedule , Hepatic Encephalopathy/diagnosis , Hepatic Encephalopathy/etiology , Multivariate Analysis , Prospective Studies , Risk Factors , Treatment Outcome , Rifaximin , India , Lactulose/adverse effects , Liver Cirrhosis/diagnosis , Neuropsychological Tests
Rev. med. interna Guatem ; 19(2): 17-25, mayo-jul. 2015.
Article in Spanish | LILACS | ID: biblio-981656


El aumento de tuberculosis y la multidrogo resistencia de cepas de micobacterias es un problema de los sistemas de salud, en 2009, en el Hospital Roosevelt Gordillo y cols, determinaron la TB-MDR en pacientes con tuberculosis diagnosticada microbiológicamente, la tasa de resistencia fue de 4.3%. Objetivo: Determinar los patrones de resistencia y perfiles genéticos de cepas con monoresistencia y cepas TB-MDR del Complejo M. tuberculosis. Métodos: Se utilizaron dos métodos para evaluar las cepas de M. tuberculosis, un método fenotípico, MGIT, y un método Genotípico, Genotype HAIN LifeScience para determinar el perfil genético de las cepas. Resultados: Se evaluaron 846 cepas de micobacterias de los años 2008 al 2013, encontrándose un 2.2% de TB-MDR. Las cepas evaluadas genotípicamente fueron 761, a las cuales se determinó los genes de resistencia, encontrándose monoresistencia a Isoniacida en 58 cepas, 7.6%, monoresistencia a Rifampicina en 18 cepas, 2.4% y 15 cepas MDR, 2.0%. Las mutaciones más frecuentes en monoresistencia fueron inhA MUT1 y katG MUT1 y la combinación de ambos genes 3.2%, 3.0% y 1.3%, para cepas TB-MDR la combinación rpoB Mutación silenciosa + katG MUT1 + inhA MUT1. Se encontró que en pacientes con cepas MDR el 3.1% son HIV+ y el 1.5% son HIV-...(AU)

Introduction: The increase of tuberculosis and multidrug resistance in mycobacteria strains is a problem for health systems, in 2009, in Hospital Roosevelt, Gordillo and cols, determined the TB-MDR in patients diagnosed with tuberculosis microbiologically, the resistance rate was 4.3%. Objective: To determine the resistance patterns and genetic profiles of monoresistant strains and MDR-TB strains of M. tuberculosis complex. Methods: Two methods for evaluating M. tuberculosis strains were used, a phenotypic method, MGIT, and a genotypic method, Genotype HAIN LifeScience to determine the genetic profile of the strains. Results: 846 strains of mycobacteria of the years 2008 to 2013 were evaluated, finding 2.2% of MDR-TB. The strains genotypically evaluated were 761, of wich, resistance genes were determined, finding isoniazid monoresistance in 58 strains, 7.6%, Rifampicin monoresistance in 18 strains, 2.4% and 15 MDR strains, 2.0%. The most frequent mutations for monoresistant strains were inhA MUT1 and katG MUT1 and the combination of both genes 3.2%, 3.0% and 1.3%, respectively, and the most frequent mutations for TB-MDR strains was the combination rpoB silent mutation + katG MUT1 + inhA MUT1. There was found that in patients with MDR strains 3.1% are HIV+ and 1.5% are HIV-. Conclusions: The percentage of TB-MDR strains was 2.3%, and the most common genes were rpoB silent mutation, inhA MUT1 y katG MUT1. There was found a higher percentage of monoresistance in isoniazid than rifampicin, being the HIV+ patient population the one that presented higher percentages in both monoresistance to RIF and INH and TB-MDR strains.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Tuberculosis, Multidrug-Resistant/diagnosis , Genes, MDR , Genes, MDR/genetics , Genotyping Techniques/statistics & numerical data , Mycobacterium tuberculosis/isolation & purification , Rifamycins/pharmacology , AIDS-Related Opportunistic Infections/drug therapy , Drug Resistance, Bacterial , Isoniazid/pharmacology
Braz. oral res. (Online) ; 29(1): 1-6, 2015. tab
Article in English | LILACS | ID: lil-777180


Guedes-Pinto paste is the filling material most employed in Brazil for endodontic treatment of deciduous teeth; however, the Rifocort® ointment has been removed. Thus, the aim of this study was to investigate the antimicrobial potential of filling pastes, by proposing three new pharmacological associations to replace Rifocort® ointment with drugs of already established antimicrobial power: Nebacetin® ointment, 2% Chlorhexidine Gluconate gel, and Maxitrol® ointment. A paste composed of Iodoform, Rifocort® ointment and Camphorated Paramonochlorophenol (CPC) was employed as the gold standard (G1). The other associations were: Iodoform, Nebacetin® ointment and CPC (G2); Iodoform, 2% Chlorhexidine Digluconate gel and CPC (G3); Iodoform, Maxitrol® ointment and CPC (G4). The associations were tested for Staphylococcus aureus (S. aureus), Streptococcus mutans (S. mutans), Streptococcus oralis (S. oralis), Enterococcus faecalis (E. faecalis), Escherichia coli (E. coli), and Bacillus subtilis (B. subtilis), using the methods of dilution on solid medium – orifice agar – and broth dilution. The results were tested using statistical analysis ANOVA and Kruskal-Wallis. They showed that all the pastes had a bacteriostatic effect on all the microorganisms, without any statistically significant difference, compared with G1. S. aureus was statistically significant (multiple comparison test of Tukey), insofar as G2 and G3 presented the worst and the best performance, respectively. All associations were bactericidal for E. coli, S. aureus, S. mutans and S. oralis. Only G3 and G4 were bactericidal for E. faecalis, whereas no product was bactericidal for B. subtilis. Thus, the tested pastes have antimicrobial potential and have proved acceptable for endodontic treatment of primary teeth.

Anti-Bacterial Agents/pharmacology , Bacteria/drug effects , Root Canal Filling Materials/pharmacology , Tooth, Deciduous/drug effects , Analysis of Variance , Bacitracin/pharmacology , Bacteria/growth & development , Chlorhexidine/analogs & derivatives , Chlorhexidine/pharmacology , Drug Combinations , Fluprednisolone/pharmacology , Microbial Sensitivity Tests , Neomycin/pharmacology , Ointments , Polymyxin B/pharmacology , Prednisolone/analogs & derivatives , Prednisolone/pharmacology , Reproducibility of Results , Rifamycins/pharmacology , Statistics, Nonparametric , Time Factors
Chinese Journal of Biotechnology ; (12): 845-856, 2015.
Article in Chinese | WPRIM | ID: wpr-240582


Nitrate not only remarkably stimulates the rifamycinbiosynthesis in Amycolatopsis mediterranei, but also influences the primary metabolisms, including the inhibition of fatty acids biosynthesis in the bacterial. This phenomenon has been designated as "Nitrate Stimulating Effect" by the late Prof. J.S. Chiaosince its discovery in the 1970's, and has been found in many other antibiotics-producing actinomycetes subsequently. Based on the research in his laboratory, we have revealed that the nitrate stimulation effect mainly manifests in two aspects over the last two decades. First, nitrate promotes the supply of rifamycin precursors, e.g., UDP-glucose, AHBA, malonyl-CoA and methylmalonyl-CoA. Specifically, the biosynthesis of fatty acids is inhibited by nitrate consequently the acetyl-CoA is shunted into malonyl-CoA. Second, nitrate facilitates the expression of genes in the rifclulsterthat encodes rifamycin biosynthetic enzymes. Following our current understanding, the future research will focus on the signals, the signal transduction pathway and the molecular mechanisms that dictate nitrate-mediated transcriptional and post-translational regulations.

Actinomycetales , Classification , Metabolism , Acyl Coenzyme A , Chemistry , Anti-Bacterial Agents , Nitrates , Chemistry , Rifamycins
Article in English | WPRIM | ID: wpr-146122


Small intestinal bacterial overgrowth (SIBO) can partly explain irritable bowel syndrome (IBS), and rifaximin has been observed to improve abdominal symptoms in nonconstipated IBS patients. However, there are few reports on the association of the rifaximin treatment periods with the results of a lactulose breath test (LBT). Therefore, we performed a retrospective review of patient charts to investigate the relation between the rifaximin treatment periods with LBT results in nonconstipated IBS patients. We also evaluated the time to achieve a symptomatic improvement in the IBS patients as compared to the changes in the LBT. We reviewed the charts for patients who showed IBS symptoms with documented positive results for LBT during their initial visit and who had a follow-up LBT after treatment with rifaximin. The LBT values were compared to the subjects' symptom scores. A total of 102 subjects had a follow-up LBT to assess LBT normalization. The subjects were divided into groups according to treatment periods of 4 weeks (n = 36), 8 weeks (n = 43), and 12 weeks (n = 23). The groups with a longer treatment exhibited an increase in the hydrogen gas value at 90 min and its sum during 90 min at the initial LBT. There were significant differences in hydrogen gas value at 90 min and in its sum during 90 min at the initial LBT between the groups treated for 4 and 12 weeks. The most significant treatment response was observed during the first 4 weeks for all treatment groups. Symptomatic improvement occurred earlier than LBT normalization in the treatment period over 4 weeks. The results indicate that different rifaximin treatment periods are needed in accordance with LBT levels to effectively eradicate SIBO.

Biomarkers/analysis , Breath Tests/methods , Constipation , Drug Administration Schedule , Drug Monitoring/methods , Female , Gastrointestinal Agents/administration & dosage , Humans , Irritable Bowel Syndrome/diagnosis , Lactulose/analysis , Male , Middle Aged , Reproducibility of Results , Rifamycins/administration & dosage , Sensitivity and Specificity , Treatment Outcome
Saudi Journal of Gastroenterology [The]. 2013; 19 (1): 56
in English | IMEMR | ID: emr-130113

Humans , Rifamycins
Article in English | WPRIM | ID: wpr-191633


Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating.

Alprostadil , Gastrointestinal Diseases , Humans , Hypersensitivity , Metagenome , Peptides , Reflex , Rifamycins , Lubiprostone
Braz. dent. j ; 23(6): 635-644, 2012. ilus, tab
Article in English | LILACS | ID: lil-662420


This study aimed to evaluate by the intra-osseous implant technique the most commonly used materials for pulp therapy in pediatric dentistry: calcium hydroxide (CH), Guedes Pinto paste and CTZ paste, according to FDI (1980) and ANSI/ADA (1982) recommendations. Thirty guinea pigs, 10 for each material, divided into experimental periods of 4 and 12 weeks received one implant on each side of the lower jaw symphysis. The external lateral tube wall served as control for the technique. At the end of the observation periods, the animals were euthanized and specimens were prepared for routine histological examination. It was observed that CH and CTZ paste induced severe inflammation, a large amount of necrotic tissue, lymphocytes, foreign body cells and bone resorption, while Guedes Pinto Paste induced little or no inflammation in the 4-week observation period. After 12 weeks, the reactions to CH and Guedes Pinto paste were also absent/mild, presenting a general pattern of replacement by recently formed bone tissue while a moderate to severe inflammatory response was observed with CTZ paste. Guedes Pinto paste presented acceptable biocompatibility levels in both analyzed periods; CH only showed acceptable biocompatibility in the 12-week period while CTZ paste showed no biocompatibility in both periods. Among the tested materials, only Guedes Pinto paste presented an acceptable biocompatibility.

A pesquisa teve como objetivo avaliar a biocompatibilidade através da técnica de implantes intra-ósseos dos materiais utilizados em odontopediatria para tratamento pulpar: hidróxido de cálcio, pastas Guedes Pinto e CTZ, de acordo com as recomendações da FDI (1980) e ANSI/ADA(1982). Trinta guinea pigs, dez para cada material, divididos em períodos experimentais de 4 e 12 semanas receberam um implante em cada lado da sínfise mandibular. A parede lateral externa do copo serviu como controle para a técnica. No final dos períodos experimentais, os animais foram sacrificados e os espécimes preparados para o exame histológico de rotina. Observou-se que o hidróxido de cálcio e a pasta CTZ mostraram reação inflamatória severa, grande quantidade de tecido necrosado, linfócitos, células de corpo estranho e reabsorção óssea; enquanto a pasta Guedes Pinto induziu pouca ou nenhuma inflamação no período de 4 semanas. Após 12 semanas as reações para o hidróxido de cálcio e pasta Guedes Pinto foram ausentes/suaves apresentando um padrão geral de substituição por tecido ósseo neoformado, enquanto uma resposta inflamatória de moderada a severa foi observada para a pasta CTZ. A pasta Guedes Pinto apresentou níveis aceitáveis de biocompatibilidade nos dois períodos analisados; hidróxido de cálcio apresentou biocompatibilidade aceitável somente no período de 12 semanas e a pasta CTZ não mostrou biocompatibilidade em ambos os períodos. Entre estes, apenas a pasta Guedes Pinto apresentou níveis de biocompatibilidade nos dois períodos analisados.

Animals , Guinea Pigs , Biocompatible Materials/pharmacology , Mandible/drug effects , Root Canal Filling Materials/pharmacology , Anti-Bacterial Agents/pharmacology , Anti-Inflammatory Agents/pharmacology , Bone Resorption/chemically induced , Calcium Hydroxide/pharmacology , Chloramphenicol/pharmacology , Drug Combinations , Eugenol/pharmacology , Giant Cells, Foreign-Body/drug effects , Hydrocarbons, Iodinated/pharmacology , Lymphocytes/drug effects , Macrophages/drug effects , Necrosis , Neutrophils/drug effects , Osteitis/chemically induced , Osteogenesis/drug effects , Prednisolone/analogs & derivatives , Prednisolone/pharmacology , Rifamycins/pharmacology , Time Factors , Tetracycline/pharmacology , Zinc Oxide/pharmacology
Ain-Shams Journal of Forensic Medicine and Clinical Toxicology. 2012; 18 (1): 102-109
in English | IMEMR | ID: emr-154189


Administration of Isoniazid [INH] and Rifampicin [RIF] the most common medication prescribed against tuberculosis, produces many metabolic and morphological aberrations in liver due to the fact thai liver is the main detoxifying site for these antitubercular drugs. This work was done to study the hepatoprotective effect of garlic and vitamin [vit] E aginst hepatotoxic effect of INH, and RIF. The expriemental work was done in Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Minia University in a period of April to June 2011. One hundred and sixty adult male albino rats weighting 150-200 grams were divided into seven groups, one control and the other six for the drugs. Control group is subdivided into four subgroups [la, Ib, Ic, Id]. Group II ingested Garlic oil, group III ingested vitamine E, group IV ingested INH+ RIF, group V ingested INH+ RIF+ Garlic oil, group VI ingested INH+ RIF+ vit E, and finally group VII ingested INH+ RIF+ Garlic oiH vit E. The ingestion was done through orogastric tube. After four weeks biochemical studies [ALT, AST, and Total Bilirubin] were done for all rats in all groups, then the rats were sacrified and histopathological studies were done for their livers. Biochemical analysis revealed significant increased in AST, ALT, and Total Bilirubin in the group IV, V, VI and VII in comparison with control groups, and revealed significant decrease in the group V, VI, and VII in comparison with group IV. Histopathological examination of the group IV revealed necro-inflammatory foci with infilteration of the hepatic lobules with inflammatory cells and inflammation in the portal tract. Histopathological examination of the liver section of group V, VI, and VII showed mild necrosis and inflammation in hepatic lobules, and showed mild inflammation in the portal tract. We concluded that the liver is highly affected by ingestion of INH and RIF. But ingestion of garlic and /or vit E which is naturally occurring antioxidants can decrease this harmful effect of these two drugs on the liver

Male , Animals, Laboratory , Rifamycins/adverse effects , Liver/pathology , Histology , Protective Agents , Garlic/adverse effects , Vitamin E , Treatment Outcome
Article in Korean | WPRIM | ID: wpr-202007


Oral antibiotics are usually prescribed for geriatric patients for the treatment of infectious diarrhea and management of hepatic encephalopathy. But oral antibiotics have systemic adverse events, so many doctors face the issue of choosing the right antibiotics. Rifaximin, an intestinal topical antibiotic that exhibits a wide antimicrobial activity against both aerobic and anaerobic bacteria, has various indications, such as acute bacterial diarrhea caused by Gram positive and negative bacteria, traveler's diarrhea, small intestine bacterial overgrowth, prevention of infection after gastrointestinal surgery, and the management of hepatic encephalopathy with hyperammoniemia. But there are few clinical trial data on the geriatric population. Hence we reviewed the clinical study data that included geriatric patients in their clinical trials. Based on our literature searches, only one clinical trial on acute bacterial diarrhea was performed only for geriatric patients. Other clinical trials for various indications usually recruited elderly patients, but the number of elderly patients was limited. However, generally speaking, rifaximin showed good efficacy and safety profile in acute bacterial diarrhea caused by Gram positive and negative bacteria, traveler's diarrhea, small intestine bacterial overgrowth, prevention of infection after gastrointestinal surgery, and the management of hepatic encephalopathy with hyperammoniemia; and there were no differences in efficacy and safety, compared to the nongeriatric population. We concluded that rifaximin is a good therapeutic option for various gastrointestinal indications, and shows good efficacy and an excellent safety profile, compared to other oral agents. For more evidence on the geriatric population, we propose clinical trials on elderly patients for each indication.

Aged , Anti-Bacterial Agents , Bacteria , Bacteria, Anaerobic , Diarrhea , Hepatic Encephalopathy , Humans , Intestine, Small , Rifamycins
Gut and Liver ; : 452-456, 2012.
Article in English | WPRIM | ID: wpr-58003


BACKGROUND/AIMS: This study assessed the efficacy of a rifaximin plus levofloxacin-based rescue regimen in patients that had failed both triple and quadruple standard regimens for the eradication of Helicobacter pylori. METHODS: We treated patients for H. pylori between August 2009 and April 2011. The triple regimen consisted of combined treatment with amoxicillin, clarithromycin, and pantoprazole for 1 week. For failed cases, a quadruple regimen of tetracycline, metronidazole, bismuth dicitrate, and lansoprazole for 1 week was administered. The rescue regimen for persistently refractory cases was rifaximin 200 mg t.i.d., levofloxacin 500 mg q.d., and lansoprazole 15 mg b.i.d. for 1 week. RESULTS: In total, 482 patients were enrolled in this study. The eradication rates associated with the first and second regimens were 58% and 60%, respectively. Forty-seven out of 58 patients who failed with the second-line regimen received rifaximin plus levofloxacin-based third-line therapy. The eradication rate for the third regimen was 65%. The cumulative eradication rates were 58%, 85%, and 96% for each regimen, respectively. CONCLUSIONS: A rifaximin plus levofloxacin-based regimen could be an alternative rescue therapy in patients with resistance to both triple and quadruple regimens for the eradication of H. pylori.

2-Pyridinylmethylsulfinylbenzimidazoles , Amoxicillin , Bismuth , Clarithromycin , Helicobacter , Helicobacter pylori , Humans , Metronidazole , Ofloxacin , Rifamycins , Tetracycline
Arch. argent. pediatr ; 109(6): 113-115, dic. 2011.
Article in Spanish | LILACS | ID: lil-633221


La rifaximina es un antibiótico recientemente aprobado para el tratamiento de la encefalopatía hepática en adultos. En niños mayores de 12 años se aprobó su uso en la diarrea del viajero y se lo emplea ampliamente en la enfermedad infamatoria intestinal. Comunicamos el primer caso del que tenemos conocimiento, de un paciente en edad pediátrica que recibió rifaximina para tratar la encefalopatía hepática, con buena respuesta clínica.

Rifaximin is an antibiotic recently approved for the treatment of hepatic encephalopathy in adults. In children more than 12 year-old, it has been approved for travelers' diarrhea and it is also widely used in infammatory bowel disease. We report, to our knowledge, the frst case of a pediatric patient who received rifaximin for hepatic encephalopathy with good clinical outcome.

Child , Female , Humans , Anti-Infective Agents/therapeutic use , Hepatic Encephalopathy/drug therapy , Rifamycins/therapeutic use
Gastroenterol. latinoam ; 22(2): 172-175, abr.-jun. 2011.
Article in Spanish | LILACS | ID: lil-661813


Hepatic encephalopathy (HE) is a neuropsychiatric and motor disorder, resulting from hepatic failure. It is one of the main manifestations of chronic liver disease and the cardinal presentation of acute liver failure. Its presence and severity are the main prognostic determinants among these patients. It is frequent in advanced chronic liver disease (30-45 percent) and in patients with TIPS (transjugular intrahepatic portosystemic shunt) (10-50 percent). Its pathogenesis is complex and it has multiple components, including ammonia, inflammatory cytokines, benzodiazepine- and manganese-like components, which alter the function of the neuronal cell. Its management requires identification and treatment of the precipitating factors, and ruling out other causes of mental status alteration. The majority of the therapies are aimed at reducing ammonia load in the intestine, such as non absorbable disaccharides (lactulose), antibiotics (neomycin, metronidazole and currently, rifaximin) and other, whose role has yet to be established. Severe encephalopathy is considered an indicator for liver transplantation. This article will analyze mainly hepatic encephalopathy in cirrhotic patients, its classification, etiopathogeny and current management.

La encefalopatía hepática (EH) es un síndrome neuropsiquiátrico y motor, que resulta de una disfunción hepática. Es una de las manifestaciones principales de la enfermedad hepática crónica y la presentación cardinal en la falla hepática aguda. Su presencia y gravedad son uno de los mayores determinantes pronósticos en estos pacientes. Es frecuente en enfermedad hepática crónica avanzada (30-45 por ciento)y en portadores de shunt postosistémico transyugular intrahepático (TIPS) (10-50 por ciento). Su patogénesis es compleja y tiene múltiples componentes, incluyendo el amonio, citoquinas inflamatorias, compuestos que semejan a benzodiacepinas y manganeso, que causan alteración funcional de la célula neuronal. El manejo requiere identificar y tratar los factores precipitantes, además de excluir otras causas de alteración del estado mental. La mayoría de las terapias están dirigidas a reducir la carga de amonio en el intestino, tales como los disacáridos no absorbibles (lactulosa), antibióticos (neomicina, metronidazol y actualmente rifaximina) y otros cuyo rol está por establecerse. La encefalopatía grave es considerada un indicador para trasplante hepático. En este artículo analizaremos principalmente la encefalopatía hepática en pacientes con cirrosis, su clasificación, etiopatogenia y manejo actual.

Humans , Hepatic Encephalopathy/physiopathology , Hepatic Encephalopathy/therapy , Ammonia/metabolism , Anti-Bacterial Agents/therapeutic use , Portasystemic Shunt, Transjugular Intrahepatic/adverse effects , Hepatic Encephalopathy/classification , Hepatic Encephalopathy/metabolism , gamma-Aminobutyric Acid , Liver Cirrhosis , Lactulose/therapeutic use , Manganese/metabolism , Rifamycins/therapeutic use , Severity of Illness Index
Article in English | WPRIM | ID: wpr-218792


Constipation, a common problem in gastroenterology practice, may result from slow colonic transit. Therapeutic options for slow transit constipations are limited. Excessive methane production by the methanogenic gut flora, which is more often found in patients with constipation, slows colonic transit. Thus, reduction in methane production with antibiotic treatment directed against methanogenic flora of the gut may accelerate colonic transit resulting in improvement in constipation. However, there is not much data to prove this hypothesis. We, therefore, report a patient with slow transit constipation associated with high methane production both in fasting state and after ingestion of glucose, whose constipation improved after treatment with non-absorbable antibiotic, rifaximin, which reduced breath methane values.

Breath Tests , Colon , Constipation , Eating , Fasting , Gastroenterology , Glucose , Humans , Hydrogen , Irritable Bowel Syndrome , Methane , Rifamycins