Skip to main content

Advertisement

SpringerLink
Log in

Effects of Rifaximin Treatment and Retreatment in Nonconstipated IBS Subjects

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Recent evidence suggests a role for gut bacteria and antibiotics in the pathophysiology and treatment of irritable bowel syndrome (IBS), respectively. While the benefits of the antibiotic rifaximin have demonstrated efficacy and durable improvement in symptoms over 3 months, the long-term need for retreatment using this approach is mostly unknown. In this retrospective study, subjects with nonconstipated IBS who were retreated with rifaximin were examined.

Methods

Charts of patients who were seen at a tertiary care medical center between 2007 and 2011 were reviewed. After exclusion criteria were applied, subjects who had received rifaximin and were seen for retreatment were fully reviewed. During review, demographic information, duration of response, and success of treatment and retreatment were evaluated.

Results

A total of 522 charts were reviewed. Of these 522 charts, 71 subjects were nonconstipated IBS subjects who had received at least one retreatment. Of these, 48 had a second, 22 had a third, 7 had a fourth, and 4 had a fifth treatment. More than 75% of subjects who initially responded to rifaximin also responded to any further retreatment, with no significant reduction in benefit for successive retreatments. Furthermore, there was no change in the duration of benefit (median time between treatments) for successive retreatments.

Conclusions

Retreatment with rifaximin for subjects with nonconstipated IBS in a real-world clinical practice was successful up to five times without decrease in duration or effect.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Bommelaer G, Poynard T, Le Pen C, et al. Prevalence of irritable bowel syndrome (IBS) and variability of diagnostic criteria. Gastroenterol Clin Biol. 2004;28:554–561.

    Article  PubMed  Google Scholar 

  2. El-Serag HB. Impact of irritable bowel syndrome: prevalence and effect on health-related quality of life. Rev Gastroenterol Disord. 2003;3:S3–S11.

    PubMed  Google Scholar 

  3. Agreus L, Svardsudd K, Nyren O, Tibblin G. Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. Gastroenterology. 1995;109:671–680.

    Article  PubMed  CAS  Google Scholar 

  4. Pyleris E, Bourboulis EG, Koussoulas B, Barbatzas C. Prevalence of small intestinal bacterial overgrowth in a greek cohort: relationship with irritable bowel syndrome. Presented at the 18th United European gastroenterology week. Barcelona, Spain, 2010.

  5. Pimentel M, Chatterjee S, Chow EJ, Park S, Kong Y. Neomycin improves constipation-predominant irritable bowel syndrome in a fashion that is dependent on the presence of methane gas: subanalysis of a double-blind randomized controlled study. Dig Dis Sci. 2006;51:1297–1301.

    Article  PubMed  CAS  Google Scholar 

  6. Sharara AI, Aoun E, Abdul-Baki H, Mounzer R, Sidani S, Elhajj I. A randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence. Am J Gastroenterol. 2006;101:326–333.

    Article  PubMed  CAS  Google Scholar 

  7. Pimentel M, Park S, Mirocha J, Kane SV, Kong Y. The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial. Ann Intern Med. 2006;145:557–563.

    PubMed  Google Scholar 

  8. Pimentel M, Lembo A, Chey WD, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011;364:22–32.

    Article  PubMed  CAS  Google Scholar 

  9. Gerard L, Garey KW, DuPont HL. Rifaximin: A nonabsorbable rifamycin antibiotic for use in nonsystemic gastrointestinal infections. Expert Rev Anti Infect Therapy. 2005;3:201–211.

    Article  CAS  Google Scholar 

  10. Jiang ZD, DuPont HL. Rifaximin: in vitro and in vivo antibacterial activity—a review. Chemotherapy. 2005;51:67–72.

    Article  PubMed  CAS  Google Scholar 

  11. Debbia EA, Maioli E, Roveta S, Marchese A. Effects of rifaximin on bacterial virulence mechanisms at supra- and sub-inhibitory concentrations. J Chemother. 2008;20:186–194.

    PubMed  CAS  Google Scholar 

  12. Yang J, Lee HR, Low K, Chatterjee S, Pimentel M. Rifaximin versus other antibiotics in the primary treatment and retreatment of bacterial overgrowth in IBS. Dig Dis Sci. 2008;53:169–174.

    Article  PubMed  CAS  Google Scholar 

  13. Ford AC, Spiegel BM, Talley NJ, Moayyedi P. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009;7:1279–1286.

    Article  PubMed  Google Scholar 

  14. Shah ED, Basseri RJ, Chong K, Pimentel M. Abnormal breath testing in IBS: a meta-analysis. Dig Dis Sci. 2010;55:2441–2449.

    Article  PubMed  Google Scholar 

  15. Posserud I, Stotzer PO, Bjornsson ES, Abrahamsson H, Simren M. Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut. 2007;56:802–808.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by the Beatrice and Samuel A. Seaver Foundation.

Author information

Authors and Affiliations

  1. GI Motility Program, Cedars-Sinai Medical Center, 8730 Alden Drive, Suite 225E, Los Angeles, CA, 90048, USA

    Mark Pimentel, Walter Morales, Kathleen Chua, Gillian Barlow, Stacy Weitsman, Gene Kim, Meridythe M. Amichai, Venkata Pokkunuri, Emily Rook, Ruchi Mathur & Zachary Marsh

Authors
  1. Mark Pimentel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Walter Morales
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathleen Chua
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gillian Barlow
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stacy Weitsman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gene Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Meridythe M. Amichai
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Venkata Pokkunuri
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Emily Rook
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ruchi Mathur
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Zachary Marsh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark Pimentel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pimentel, M., Morales, W., Chua, K. et al. Effects of Rifaximin Treatment and Retreatment in Nonconstipated IBS Subjects. Dig Dis Sci 56, 2067–2072 (2011). https://doi.org/10.1007/s10620-011-1728-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-011-1728-5

Keywords

Search

Navigation