Rifaximin, a nonabsorbed oral antibiotic, prevents shigellosis after experimental challenge

David N. Taylor, Robin McKenzie, Anna Durbin, Colleen Carpenter, Christophe B. Atzinger, Robert Haake, A. Louis Bourgeois

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


Background. This double-blind, placebo-controlled study was conducted to assess the efficacy of the non-absorbed oral antibiotic rifaximin to prevent shigellosis in volunteers challenged with Shigella flexneri. Methods. Volunteers were randomized to receive either prophylactic rifaximin (200 mg 3 times daily for 3 days; n = 15) or placebo (n = 10) on days 0, 1, and 2. On day 1, volunteers were challenged with ∼1500 colonyforming units of S. flexneri 2a strain 2457T given orally in sodium bicarbonate buffer. Results. The incidence of diarrhea was 0 with rifaximin, compared with 60% with placebo (P = .001). The median time to onset of diarrhea was 78.5 h with placebo (P < .001). The incidence of dysentery was 0 for rifaximin and 10% for placebo (P = .4). The incidence of colonization with Shigella was 0 with rifaximin, compared with 50% with placebo (P< .005). A significant serum or mucosal immune response after challenge by at least 1 indicator (immunoglobulin A titer, immunoglobulin G titer, and immunoglobulin A antibody-secreting cell count) was 0 with rifaximin and 80% with placebo (P<.001). Conclusions. Rifaximin was effective and well tolerated, compared with placebo, in preventing shigellosis in this double-blind study of volunteers challenged with S. flexneri 2a.

Original languageEnglish (US)
Pages (from-to)1283-1288
Number of pages6
JournalClinical Infectious Diseases
Issue number9
StatePublished - May 1 2006

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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