Use of rifaximin in gastrointestinal and liver diseases

Table 1 Proposed treatment regimen(s) with rifaximin by indication

Disorder	Evidence of beneficial effect	Recommended regimen	Ref.
IBS	Randomized controlled multicenter studies show improvement in global IBS symptoms	400-550 mg three times daily for 2 wk May require intermittent retreatment	[87,88]
Treatment of TD	Randomized controlled trials show reduced duration of the illness	200 mg three times daily for 3 d	[94,95]
Prevention of TD	Randomized controlled trials in patients traveling to south and southeast Asia; and Mexico	200 mg twice daily or 600 mg daily while in high risk area	[97,98]
SIBO	Rifaximin normalizes the hydrogen breath test and improves symptoms	400 mg three times daily for 2 wk May require retreatment	[99-101]
Hepatic encephalopathy	Randomized controlled trials, proved efficacy and safety	550 mg 2 or 3 times daily chronically	[104-106]
Diverticular disease	Randomized controlled trials showed that rifaximin improves symptoms and prevents recurrence	400 mg twice daily for 7 d every month	[110-115]
IBD and pouchitis	Observational data and small pilot studies Retrospective study	400-800 mg twice daily for 12 wk May require retreatment or intermittent treatment 400 mg three times daily chronically	[125-129] [136]
SBP prophylaxis
Recurrent Clostridium difficile infection	Small case series and retrospective studies	400 mg twice daily for 2 wk	[140-142]

IBS: Irritable bowel syndrome; TD: Traveler’s diarrhea; SIBO: Small intestinal bacterial overgrowth; IBD: Inflammatory bowel disease; SBP: Spontaneous bacterial peritonitis.