Non-absorbed Antibiotics for IBS

Brooks D Cash

doi:10.4172/2329-6631.1000e111

Abstract

Abstract : A recent manuscript [1] described two multi-center, prospective double blind trials of the non-absorbed antibiotic rifaximin for nonconstipated irritable bowel syndrome (IBS). This effort adds to the body of literature from other, smaller studies that have demonstrated clinical efficacy for IBS with rifaximin. Non-absorbed antibiotics have been endorsed by the American College of Gastroenterology IBS Task Force as potentially useful therapy for IBS [2]. Interest in this approach stems from the increasing recognition of enteric bacterial imbalances in some patients with IBS compared to non-IBS controls [3-4]. An early study of antibiotics for IBS involved 87 patients with IBS randomized to rifaximin 400 mg three times daily for 10 days or placebo. During the initial 2 weeks of therapy and the subsequent 10 weeks of follow-up rifaximin resulted in statistically significantly greater improvement in IBS symptoms than placebo [5]. The report by Pimentel et al. represents a significant advance in our knowledge and understanding of the effects of rifaximin for IBS.

Highlights

A recent manuscript [1] described two multi-center, prospective, double blind trials of the non-absorbed antibiotic rifaximin for nonconstipated irritable bowel syndrome (IBS)
The diagnosis of IBS is made after careful exclusion of other pathophysiological disturbances that could result in the hallmark symptoms of abdominal pain accompanying altered bowel habits and application of symptom-based criteria such as the Rome diagnostic criteria for IBS [6,7,8]
Establishing reliable and reproducible barometers for determining severity of IBS symptoms and their impact are sorely needed as inclusion of patients with differing degrees of severity could affect the results of clinical trials of therapeutic agents and lead to the promotion of misleading conclusions that may not translate to clinical practice

Summary

Introduction

A recent manuscript [1] described two multi-center, prospective, double blind trials of the non-absorbed antibiotic rifaximin for nonconstipated irritable bowel syndrome (IBS). An early study of antibiotics for IBS involved 87 patients with IBS randomized to rifaximin 400 mg three times daily for 10 days or placebo.

Results

Conclusion