Editorial
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World J Gastroenterol. Nov 14, 2011; 17(42): 4643-4646
Published online Nov 14, 2011. doi: 10.3748/wjg.v17.i42.4643
Rifaximin in the treatment of inflammatory bowel disease
Mario Guslandi
Mario Guslandi, Gastroenterology Unit, S Raffaele University Hospital, 20132 Milan, Italy
Author contributions: Guslandi M contributed solely to this editorial.
Correspondence to: Mario Guslandi, Professor, Gastroenterology Unit, S Raffaele University Hospital, Via Olgettina 60, 20132 Milan, Italy. guslandi.mario@hsr.it
Telephone: +39-02-26432744 Fax: +39-02-26433491
Received: February 24, 2011
Revised: May 26, 2011
Accepted: June 2, 2011
Published online: November 14, 2011
Abstract

The gut microbiota plays a role in promoting and maintaining inflammation in inflammatory bowel diseases (IBD), hence the rationale for the use of antibiotics in the treatment of those disorders. Antibiotics, however, may induce untoward effects, especially during long-term therapy. Rifaximin α polymer is an antibacterial agent that is virtually unabsorbed after oral administration and is devoid of systemic side effects. Rifaximin has provided promising results in inducing remission of Crohn’s disease (up to 69% in open studies and significantly higher rates than placebo in double blind trials) and ulcerative colitis (76% in open studies and significantly higher rates than placebo in controlled studies) and might also have a role in maintaining remission of ulcerative colitis and pouchitis. The potential therapeutic activity of rifaximin in IBD deserves to be further investigated and confirmed in larger, controlled studies. The optimal dosage still needs to be better defined.

Keywords: Antibiotics, Gut microbiota, Inflammatory bowel disease, Rifaximin