TY - JOUR
T1 - Enteroaggregative Escherichia coli diarrhea in travelers
T2 - Response to rifaximin therapy
AU - Infante, Rosa M.
AU - Ericsson, Charles D.
AU - Jiang, Zhi Dong
AU - Ke, Shi
AU - Steffen, Robert
AU - Riopel, Lise
AU - Sack, David A.
AU - DuPont, Herbert L.
PY - 2004/2
Y1 - 2004/2
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0842283217&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0842283217&partnerID=8YFLogxK
U2 - 10.1016/S1542-3565(03)00322-7
DO - 10.1016/S1542-3565(03)00322-7
M3 - Article
C2 - 15017618
AN - SCOPUS:0842283217
SN - 1542-3565
VL - 2
SP - 135
EP - 138
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 2
ER -