Does Rifaximin Chemoprophylaxis Prevent Campylobacteriosis in the Human Challenge Model?

Abstract

This study showed no significant difference in the development of the primary endpoint, Campylobacteriosis, between subjects treated with rifaximin or placebo. However, the difference in mean total loose stool output (mL) is significantly reduced in the rifaximin group, and within this group a reduction in the maximum volume of loose stools in 24 hours was also observed. Therefore, whilst rifaximin does not protect against Campylobacteriosis, this objective data relating to stool volume suggests that fluid loss is reduced, and therefore should be considered when evaluating the efficacy of rifaximin in reducing the severity of the burden of disease in all cause bacterial travelers’ diarrhea. Based on the high diarrhea attack rates noted in this human challenge model, the efficacy of rifaximin chemoprophylaxis against campylobacteriosis in a field setting requires further evaluation. Clayton D. Harro1, Joanna E. Rimmer2,3,4, David A. Sack1, Kawsar R. Talaat1, Ramiro L. Gutierrez2, Barbara DeNearing1, Chad K. Porter2, Jessica Brubaker1, Alexander C. Maue2, Renee M. Laird2, Frederic Poly2, Patricia Guerry2, Kayla Jaep2, Ashley Alcala2, David R. Tribble5 and Mark S. Riddle2. 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 2Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, 3School of Immunity and Infection, University of Birmingham, Birmingham, United Kingdom, 4Academic Department of Military Medicine, Royal Centre for Defence Medicine (Academia and Research), Medical Directorate, Joint Medical Command, ICT Centre, Birmingham Research Park, B15 2SQ Birmingham, UK, 5Infectious Disease Clinical Research Program (IDCRP), Uniformed Services University of the Health Sciences, Bethesda, MD Does Rifaximin Chemoprophylaxis Prevent Campylobacteriosis in the Human Challenge Model?