Rifaximin is a poorly absorbed rifamycin drug with unique pharmacokinetic properties: bile
solubility making it highly active against pathogenic and non-pathogenic bacterial flora in the bile-rich
small bowel and low water solubility making it active only against highly susceptible bacteria,
primarily anaerobes, in the aqueous colon. The drug has anti-inflammatory gut mucosal stabilization
properties that are important to its sustained effects in non-infectious diseases. Rifaximin is used
chronically or recurrently for hepatic encephalopathy and diarrhea-predominant irritable bowel
syndrome. Monitoring of long-term use of rifaximin for development of resistance and then determining whether
developed resistance is associated with reduced efficacy are needed. Studies of changes of intestinal flora during therapy
and the health implications of these changes are also needed.
Keywords: Bile salts, Crohn’s disease, hepatic encephalopathy, inflammatory bowel disease, Rifaximin.
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