Enteroaggregative Escherichia coli diarrhea in travelers: Response to rifaximin therapy

Rosa M. Infante, Charles D. Ericsson, Zhi Dong Jiang, Shi Ke, Robert Steffen, Lise Riopel, David A. Sack, Herbert L. DuPont

Research output: Contribution to journalArticlepeer-review

Abstract

Background & Aims: We have recently shown that enteroaggregative Escherichia coli (EAEC) strains commonly cause travelers' diarrhea. The study was designed to determine whether U.S. travelers with EAEC diarrhea responded to rifaximin therapy. Methods: In a multicenter placebo-controlled clinical trial of travelers' diarrhea without non-EAEC pathogens we evaluated 2 doses of rifaximin. EAEC was sought in stool samples in enrolled subjects by HEp-2 cell assay. Response to rifaximin (both groups combined) and placebo were evaluated in EAEC-positive and EAEC-negative patient groups. Results: Compared with placebo, rifaximin shortened the postenrollment illness in travelers with EAEC diarrhea (median, 22 vs. 72 hours; P = 0.03). In subjects with EAEC-negative diarrhea, the median duration of post-treatment diarrhea was shorter with rifaximin (33 hours) than with placebo (52 hours), but this difference was not significantly different (P = 0.14). Conclusions: Improvement of EAEC-mediated diarrhea with antibiotic treatment supports the pathogenicity of this organism in travelers to developing countries. The study provides information on the value of the poorly absorbed drug rifaximin in therapy of travelers' diarrhea.

Original languageEnglish (US)
Pages (from-to)135-138
Number of pages4
JournalClinical Gastroenterology and Hepatology
Volume2
Issue number2
DOIs
StatePublished - Feb 2004

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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