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Rifaximin

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https://www.readbyqxmd.com/read/29924052/molecular-epidemiology-and-antimicrobial-susceptibility-of-human-clostridium-difficile-isolates-from-a-single-institution-in-northern-china
#1
Baoya Wang, Zhi Lv, Pingping Zhang, Jianrong Su
Because the epidemiology of Clostridium difficile infection (CDI) is region-specific, the present study was undertaken to examine the epidemiology of C difficile outbreaks in Beijing, China.Eighty nonduplicate isolates were collected from March, 2016 to December, 2016. The molecular type and phylogenetic analysis were evaluated by multilocus sequence typing (MLST). The minimum inhibitory concentrations (MICs) for 11 antibiotics and the resistance mechanisms were investigated.Sixty-five toxigenic strains (81...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29904078/deciphering-the-late-steps-of-rifamycin-biosynthesis
#2
Feifei Qi, Chao Lei, Fengwei Li, Xingwang Zhang, Jin Wang, Wei Zhang, Zhen Fan, Weichao Li, Gong-Li Tang, Youli Xiao, Guoping Zhao, Shengying Li
Rifamycin-derived drugs, including rifampin, rifabutin, rifapentine, and rifaximin, have long been used as first-line therapies for the treatment of tuberculosis and other deadly infections. However, the late steps leading to the biosynthesis of the industrially important rifamycin SV and B remain largely unknown. Here, we characterize a network of reactions underlying the biosynthesis of rifamycin SV, S, L, O, and B. The two-subunit transketolase Rif15 and the cytochrome P450 enzyme Rif16 are found to mediate, respectively, a unique C-O bond formation in rifamycin L and an atypical P450 ester-to-ether transformation from rifamycin L to B...
June 14, 2018: Nature Communications
https://www.readbyqxmd.com/read/29897844/pharmacokinetic-drug-evaluation-of-rifaximin-for-treatment-of-diarrhea-predominant-irritable-bowel-syndrome
#3
Eugenia Bruzzese, Marcella Pesce, Giovanni Sarnelli, Alfredo Guarino
INTRODUCTION: Rifaximin is a poorly absorbable antibiotic with a broad-spectrum activity against both Gram-negative and -positive bacteria. It is active in the small intestine due to its high bile solubility, whereas in the aqueous environment of the colon, it shows limited efficacy against highly susceptible bacteria. These unique pharmacokinetic properties limit its systemic effects and can correct gut microflora imbalances. Thus, rifaximin has become a major therapeutic agent in several gastrointestinal diseases in which an imbalance in gut microflora may play a role, including diarrhea predominant irritable bowel syndrome (IBS-D)...
June 13, 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29881992/myosteatosis-and-sarcopenia-are-associated-with-hepatic-encephalopathy-in-patients-with-cirrhosis
#4
Rahima A Bhanji, Carlos Moctezuma-Velazquez, Andres Duarte-Rojo, Maryam Ebadi, Sunita Ghosh, Christopher Rose, Aldo J Montano-Loza
BACKGROUND: Skeletal muscle is known to play a role in hepatic encephalopathy. Fatty infiltration of the muscle (myosteatosis) and muscle mass depletion (sarcopenia) are frequent complications of cirrhosis. PURPOSE: The purposes of the study were to investigate if myosteatosis and sarcopenia are associated with overt hepatic encephalopathy in patients with cirrhosis and to evaluate their impact on mortality. METHODS: A total of 675 cirrhotic patients were studied...
June 7, 2018: Hepatology International
https://www.readbyqxmd.com/read/29872332/a-model-of-blood-ammonia-homeostasis-based-on-a-quantitative-analysis-of-nitrogen-metabolism-in-the-multiple-organs-involved-in-the-production-catabolism-and-excretion-of-ammonia-in-humans
#5
REVIEW
David G Levitt, Michael D Levitt
Increased blood ammonia (NH3 ) is an important causative factor in hepatic encephalopathy, and clinical treatment of hepatic encephalopathy is focused on lowering NH3 . Ammonia is a central element in intraorgan nitrogen (N) transport, and modeling the factors that determine blood-NH3 concentration is complicated by the need to account for a variety of reactions carried out in multiple organs. This review presents a detailed quantitative analysis of the major factors determining blood-NH3 homeostasis - the N metabolism of urea, NH3 , and amino acids by the liver, gastrointestinal system, muscle, kidney, and brain - with the ultimate goal of creating a model that allows for prediction of blood-NH3 concentration...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29870990/treatment-perspectives-in-crohn-s-disease
#6
Marcel Vetter, Markus F Neurath
BACKGROUND: Crohn's disease (CD) is a chronic immune-mediated disorder of the gastrointestinal tract. The pathophysiological understanding of this disease is limited and no curative therapy is available so far. Therefore, most patients require long-lasting or even life-long immunosuppressive therapies for the suppression of symptoms to improve quality of life and reduction of long-term risks. However, in a relevant subgroup of patients, these therapeutic goals cannot be sufficiently attained...
June 5, 2018: Digestion
https://www.readbyqxmd.com/read/29865875/the-intriguing-role-of-rifaximin-in-gut-barrier-chronic-inflammation-and-in-the-treatment-of-crohn-s-disease
#7
Loris R Lopetuso, Marco Napoli, Gianenrico Rizzatti, Antonio Gasbarrini
The gastrointestinal tract acts as a functional unit organized as a semipermeable multilayer system, in which commensal gut microbiota represents the anatomical barrier. Recently,, several studies have highlighted the involvement of gut microbiota in IBD pathogenesis, in sustaining gut barrier chronic inflammation, and in conditioning disease course and therapeutical response. This evidence provides a rationale for treating patients with gut microbiota modifiers. Among these, Rifaximin represents a non-traditional antibiotic able to act as a "eubiotic" on intestinal barrier...
June 4, 2018: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/29844795/management-of-colonic-diverticular-disease-in-the-third-millennium-highlights-from-a-symposium-held-during-the-united-european-gastroenterology-week-2017
#8
REVIEW
Carmelo Scarpignato, Giovanni Barbara, Angel Lanas, Lisa L Strate
Diverticulosis is a common anatomical condition, which appears to be age-dependent. Individuals who develop chronic gastrointestinal symptoms or complications are referred to as having diverticular disease. Although the diagnosis of this condition can be relatively straightforward, randomized controlled trials are scarce and management often follows tradition rather than principles of evidence-based medicine. This report deals with the topics discussed during a symposium held during the United European Gastroenterology Week (Barcelona, October 2017)...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29807873/new-concepts-on-intestinal-microbiota-and-the-role-of-the-non-absorbable-antibiotics-with-special-reference-to-rifaximin-in-digestive-diseases
#9
REVIEW
Jasmohan S Bajaj, Giovanni Barbara, Herbert L DuPont, F Mearin, Antonio Gasbarrini, Jan Tack
Digestive diseases are a broad range of chronic disorders that substantially and negatively impact the patients' quality of life. Here, we review our current understanding on the pathophysiology of hepatic encephalopathy, irritable bowel syndrome, and diverticular disease, with a special focus on the gut microbiota composition associated with these disorders. Furthermore, we review the current clinical practice for their therapeutic treatments, including probiotics, diet change, non-adsorbable disaccharides, and antibiotics...
April 27, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29802886/antimicrobial-susceptibility-of-clostridium-difficile-isolated-from-food-and-environmental-sources-in-western-australia
#10
Su-Chen Lim, Grace O Androga, Daniel R Knight, Peter Moono, Niki F Foster, Thomas V Riley
We recently reported a high prevalence of Clostridium difficile in retail vegetables, compost and lawn in Western Australia (WA). The objective of this study was to investigate the antimicrobial susceptibility of previously isolated food and environmental C. difficile isolates of WA. A total of 274 C. difficile isolates from vegetables, compost and lawn were tested for susceptibility to a panel of 10 antimicrobial agents (fidaxomicin, vancomycin, metronidazole, rifaximin, clindamycin, erythromycin, amoxicillin/clavulanate, moxifloxacin, meropenem and tetracycline) using an agar incorporation method...
May 23, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29762873/l-ornithine-l-aspartate-for-prevention-and-treatment-of-hepatic-encephalopathy-in-people-with-cirrhosis
#11
REVIEW
Ee Teng Goh, Caroline S Stokes, Sandeep S Sidhu, Hendrik Vilstrup, Lise Lotte Gluud, Marsha Y Morgan
BACKGROUND: Hepatic encephalopathy is a common complication of cirrhosis and has high associated morbidity and mortality. The condition is classified as overt if it is clinically apparent or minimal if only evident though psychometric testing. The exact pathogenesis of this syndrome is unknown although ammonia is thought to play a key role. L-ornithine L-aspartate has ammonia-lowering properties and may, therefore, benefit people with cirrhosis and hepatic encephalopathy. OBJECTIVES: To evaluate the beneficial and harmful effects of L-ornithine L-aspartate versus placebo, no intervention, or other active interventions in people with cirrhosis and hepatic encephalopathy...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29722812/antibiotics-in-ibd-still-a-role-in-the-biological-era
#12
Oren Ledder, Dan Turner
Despite compelling evidence pointing to a critical role of gut microflora in inflammatory bowel disease (IBD) pathogenesis, the role of antibiotics in clinical practice remains limited, largely due to heterogeneous trials with often conflicting evidence. In this review, we revisit previous randomized controlled trials and high-quality uncontrolled studies in an effort to better elucidate the role of antibiotics in contemporary treatment algorithms. The most established role of antibiotics is in perianal Crohn's disease (CD), utilizing ciprofloxacin with or without metronidazole often as an adjunct to biological therapy...
May 2, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29713909/effects-of-rifaximin-on-central-responses-to-social-stress-a-pilot-experiment
#13
Huiying Wang, Christoph Braun, Paul Enck
Probiotics that promote the gut microbiota have been reported to reduce stress responses, and improve memory and mood. Whether and how antibiotics that eliminate or inhibit pathogenic and commensal gut bacteria also affect central nervous system functions in humans is so far unknown. In a double-blinded randomized study, 16 healthy volunteers (27.00 ± 1.60 years; 9 males) received either rifaximin (600 mg/day) (a poorly absorbable antibiotic) or placebo for 7 days. Before and after the drug intervention, brain activities during rest and during a social stressor inducing feelings of exclusion (Cyberball game) were measured using magnetoencephalography...
April 30, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/29713630/novel-antimicrobials-for-the-treatment-of-clostridium-difficile-infection
#14
REVIEW
Nicola Petrosillo, Guido Granata, Maria Adriana Cataldo
The current picture of Clostridium difficile infection (CDI) is alarming with a mortality rate ranging between 3% and 15% and a CDI recurrence rate ranging from 12% to 40%. Despite the great efforts made over the past 10 years to face the CDI burden, there are still gray areas in our knowledge on CDI management. The traditional anti-CDI antimicrobials are not always adequate in addressing the current needs in CDI management. The aim of our review is to give an update on novel antimicrobials for the treatment of CDI, considering the currently available evidences on their efficacy, safety, molecular mechanism of action, and their probability to be successfully introduced into the clinical practice in the near future...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29708822/rifaximin-is-associated-with-modest-transient-decreases-in-multiple-taxa-in-the-gut-microbiota-of-patients-with-diarrhoea-predominant-irritable-bowel-syndrome
#15
Anthony A Fodor, Mark Pimentel, William D Chey, Anthony Lembo, Pamela L Golden, Robert J Israel, Ian M Carroll
Rifaximin, a non-systemic antibiotic, is efficacious for the treatment of diarrhoea-predominant irritable bowel syndrome (IBS-D). Given the emerging association between the gut microbiota and IBS, this study examined potential effects of rifaximin on the gastrointestinal microbial community in patients with IBS-D. TARGET 3 was a randomised, double-blind, placebo-controlled, phase 3 study. Patients with IBS-D initially received open-label rifaximin 550 mg 3 times daily (TID) for 2 weeks. Patients who responded to the initial treatment and then relapsed were randomised to receive 2 repeat courses of rifaximin 550 mg TID or placebo for 2 weeks, with each course separated by 10 weeks...
April 30, 2018: Gut Microbes
https://www.readbyqxmd.com/read/29705917/management-of-hepatic-encephalopathy-not-responsive-to-first-line-treatments
#16
REVIEW
Silvia Nardelli, Lorenzo Ridola, Stefania Gioia, Oliviero Riggio
PURPOSE OF REVIEW: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome that occurs in up to 30% of patients with cirrhosis. HE may be a consequence of pure liver failure, as in patients with fulminant hepatitis, or of the combination of liver failure and portal-systemic shunting, as in patients with liver cirrhosis. Episodes of HE are usually related to precipitating events, such as infections or gastrointestinal bleeding; a minority of cirrhotic patients experienced a chronic HE, refractory to standard medical treatment...
June 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29678362/bowel-symptoms-in-patients-that-receive-proton-pump-inhibitors-results-of-a-multicenter-survey-in-mexico
#17
M J Schmulson, A C Frati-Munari
INTRODUCTION: Proton pump inhibitors (PPIs) have been associated with small intestinal bacterial overgrowth (SIBO), which increases with prolonged PPI use, and SIBO has been associated with irritable bowel syndrome (IBS). OBJECTIVE: The aim of the present study was to study the prevalence of bowel symptoms in patients treated with PPIs in Mexico. METHODS: Gastroenterologists in 36 cities surveyed patients treated with PPIs, utilizing an ad hoc questionnaire to determine the presence of bowel symptoms and IBS...
April 17, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29665102/antibiotic-associated-disruption-of-microbiota-composition-and-function-in-cirrhosis-is-restored-by-fecal-transplant
#18
Jasmohan S Bajaj, Genta Kakiyama, Tor Savidge, Hajime Takei, Zain A Kassam, Andrew Fagan, Edith A Gavis, William M Pandak, Hiroshi Nittono, Phillip B Hylemon, Prapaporn Boonma, Anthony Haag, Douglas M Heuman, Michael Fuchs, Binu John, Masoumeh Sikaroodi, Patrick M Gillevet
Cirrhotic patients are often exposed to antibiotics that can lead to resistance and fungal overgrowth. The role of fecal microbial transplant (FMT) to restore gut microbial function is unclear in cirrhosis. In an FDA-monitored Phase 1 clinical safety trial, decompensated cirrhotic patients on standard therapies (lactulose and rifaximin) were randomized to standard-of-care (SOC, no antibiotics/FMT) or 5 days of broad-spectrum antibiotics followed by FMT from a donor enriched in Lachnospiraceae and Ruminococcaceae...
April 17, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29651649/systematic-review-of-the-economic-burden-of-overt-hepatic-encephalopathy-and-pharmacoeconomic-impact-of-rifaximin
#19
REVIEW
Guy Neff, Woodie Zachry Iii
BACKGROUND: Hepatic encephalopathy (HE), a common neurologic complication in cirrhosis, is associated with substantial disease and economic burden. Rifaximin is a non-systemic antibiotic that reduces the risk of overt HE recurrence and overt HE-related hospitalizations. OBJECTIVE: Our objective was to provide an overview of the direct HE-related costs and cost benefits of rifaximin, lactulose, and rifaximin plus lactulose. METHODS: A systematic review of PubMed and relevant meeting abstracts was conducted to identify publications since 1 January 2007 reporting economic data related to HE and rifaximin and/or lactulose...
April 12, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29644492/update-on-the-therapeutic-management-of-hepatic-encephalopathy
#20
REVIEW
Linda Skibsted Kornerup, Lise Lotte Gluud, Hendrik Vilstrup, Gitte Dam
PURPOSE OF REVIEW: Hepatic encephalopathy (HE) is a common and devastating complication to chronic liver disease. In this paper, we summarize the latest research and evidence of both conventional and up-coming treatments. RECENT FINDINGS: Meta-analyses report beneficial effects of lactulose, branched-chain amino acids, rifaximin, and to some degree L-ornithine L-aspartate on the manifestations of HE in patients with cirrhosis, and generally the numbers needed to treat are low...
April 11, 2018: Current Gastroenterology Reports
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