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Therapeutic Effects and Mechanisms of Action of Rifaximin in Gastrointestinal Diseases
Herbert L. DuPont, MD, MACP Mayo Clinic Proceedings Volume 90, Issue 8, Pages (August 2015) DOI: /j.mayocp Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions
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Figure 1 Chemical structure of rifaximin (C43H51N3O11).
Reprinted from Xifaxan (rifaximin) tablets [package insert],1 with permission from Salix Pharmaceuticals, Ltd. Mayo Clinic Proceedings , DOI: ( /j.mayocp ) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions
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Figure 2 In an animal model, treatment with rifaximin for 10 days and subsequent assessment 30 days posttreatment indicated a decrease in bacterial counts as measured by qPCR, but a long-term effect was restricted to the duodenum. qPCR = quantitative polymerase chain reaction. ∗P=.08. From Dig Dis Sci,45 with permission. Mayo Clinic Proceedings , DOI: ( /j.mayocp ) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions
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Figure 3 In an in vitro model, rifaximin treatment of HEp-2 (laryngeal) cells decreased EAEC bacterial adhesion (A) and rifaximin treatment of A549 (lung) cells after incubation with Bacillus anthracis decreased bacterial internalization (B). EAEC = enteroaggregative Escherichia coli. ∗P<.002. From Antimicrob Agents Chemother,44 with permission. Mayo Clinic Proceedings , DOI: ( /j.mayocp ) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions
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Figure 4 Proposed mechanisms of action of rifaximin as a gut microenvironment modulator with cytoprotection properties and effects on various gastrointestinal conditions. HE = hepatic encephalopathy; IBS-D = diarrhea-predominant irritable bowel syndrome; TD = travelers’ diarrhea. Mayo Clinic Proceedings , DOI: ( /j.mayocp ) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions
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