Rifaximin, a Peculiar Rifamycin Derivative: Established and Potential Clinical Use Outside the Gastrointestinal Tract

Vol. 51, Suppl. 1, 2005

Free Abstract Article (References) Article (PDF 224 KB)

Rifaximin: A Poorly Absorbed Antibiotic
Pharmacology and Clinical Use
Guest Editor: Carmelo Scarpignato, Parma

Paper

Rifaximin, a Peculiar Rifamycin Derivative: Established and Potential Clinical Use Outside the Gastrointestinal Tract
Iva Pelosini, Carmelo Scarpignato

Laboratory of Clinical Pharmacology, Department of Human Anatomy, Pharmacology and Forensic Sciences, School of Medicine and Dentistry, University of Parma, Parma, Italy

Address of Corresponding Author

Chemotherapy 2005;51 (Suppl. 1):122-130 (DOI: 10.1159/000081999)

Key Words

Rifaximin
Rifamycin
Antibiotic therapy
Skin infections
Vaginosis, bacterial
Periodontal disease

Abstract

Rifaximin is a poorly absorbed semisynthetic rifamycin derivative with a broad spectrum of antibacterial activity including Gram-positive and Gram-negative bacteria, both aerobes and anaerobes. Although originally developed for the treatment of infectious diarrhea, the appreciation of the pathogenic role of gut bacteria in several organic and functional gastrointestinal diseases has increasingly broadened its clinical use. The availability of a topical formulation (a cream containing 5% of the drug) and the lack of transcutaneous absorption pointed out in both animal and human studies has allowed its topical use in skin infections. Furthermore, since the spectrum of antibacterial action of rifaximin includes many organisms (e.g. Bacteroides bivius-disiens, Gardnerella vaginalis, Haemophilus ducreyi) causing genital infections, including Trichomonas vaginalis and Chlamydia trachomatis, its local application in the treatment of bacterial vaginosis (BV) has been attempted. Finally, since periodontal disease, caused by plaque (an aggregate of various bacteria), can be considered a 'local' infection, intrapocket rifaximin was tried in the treatment of periodontal infections. While the efficacy in pyogenic infections of the skin has been confirmed by several investigations, which showed an improvement of both subjective and objective parameters significantly better than that of the reference drug (i.e. chlortetracycline or oxytetracycline), the usefulness of rifaximin in BV and periodontal disease needs to be further studied in well-designed clinical trials.

Author Contacts

Prof. Carmelo Scarpignato, MD, DSc, PharmD, FCP, FACG
Laboratory of Clinical Pharmacology, School of Medicine and Dentistry
University of Parma, Via Volturno, 39
IT-43100 Parma (Italy)
Tel. +39 0521 903863, eFax +1 603 8435621, E-Mail scarpi@tin.it

Article Information

Number of Print Pages : 9
Number of Figures : 2, Number of Tables : 3, Number of References : 71

Medline Abstract (ID 15855757)

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