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Use of Rifaximin Effective in Children With Inflammatory Bowel Disease: Presented at ACG By Danny Kucharsky PHILADELPHIA, PA -- October 25, 2007 -- Rifaximin significantly improves clinical symptoms in children with inflammatory bowel disease, according to a study presented here at the annual scientific meeting of the American College of Gastroenterology. The retrospective chart review of children with inflammatory bowel disease treated with rifaximin was presented by Pramodha Muniyappa, MD, Paediatric Gastroenterologist, Cleveland Clinic, Cleveland, Ohio, United States. Dr. Muniyappa and colleagues conducted their study to determine whether rifaximin is an option for use in paediatric patients with inflammatory bowel disease. Rifaximin has an indication for traveller's diarrhoea in the U.S. but studies in adults of rifaximin have shown promising results in inflammatory bowel disease. The researchers evaluated 11 patients with ulcerative colitis and 12 with Crohn's disease, with a median age of 13 years. Patients received rifaximin at doses ranging from 400 mg to 1200 mg daily. Symptom improvement and time lag to improvement were evaluated while patients were on rifaximin. At baseline, diarrhoea was the most common complaint (87%), followed by abdominal pain (74%) and bloody stools (65%). Of the 20 patients with diarrhoea, 12 had relief of diarrhoea within 4 weeks of starting rifaximin, and 5 patients within 1 week. Among patients with abdominal pain, 12 had relief within 4 weeks, and 3 within 1 week. Visible bleeding resolved in 10 of 15 patients within 4 weeks of therapy, and 3 of the 10 had improvement within 1 week. One patient had a negative side effect, a temporary increase in diarrhoea symptoms after starting rifaximin. It resolved within 3 weeks without further therapy or complications. Eighty percent of patients had moderate to optimal improvement in abdominal pain on 1200 mg/day of rifaximin versus 17% who received 400 mg/day (P =.046). "Our data supports the use of higher total doses of rifaximin for symptom relief, specifically for abdominal pain," Dr. Muniyappa said. The fact rifaximin is essentially non-absorbable and has a topical effect supports this finding. Dr. Muniyappa noted. Standard doses need to be evaluated for establishing optimal therapy and more needs to be learnt about the use of rifaximin in children with inflammatory bowel disease. The retrospective review was limited by small sample size, random dosing schedules, and lack of consistent laboratory monitoring and data collection, Dr. Muniyappa added. However, "our study has indicated that rifaximin has the potential to be an efficacious and safe antibiotic for use in paediatric inflammatory bowel disease though its use at this time would be off label," he concluded. [Presentation title: Use of Rifaximin in Pediatric Patients With Inflammatory Bowel Disease. Abstract 667] E-mail this page to a friend or colleague! To print, use this version