Rifaximin Therapy effective against Metronidazole-resistant Clostridium difficile Infection

In a new study conducted by Muhammad Waqas and team it was found that in more than 65 percent of instances, rifaximin medication is beneficial for patients with Clostridium difficile infection (CDI) who are resistant to metronidazole. The findings of this study were published in Cureus Journal.

Infection with Clostridium difficile is a major cause of hospital-acquired diarrhea. Rifaximin is an antibiotic with limited resistance to Clostridium difficile bacteria. The purpose of this study was to determine the effectiveness of rifaximin in metronidazole-resistant CDI patients.

A cross-sectional study was conducted at the Lahore General Hospital in Lahore, Pakistan, from August 2019 to May 2020. A total of 200 instances were included in the study. Patients with CDI had diarrhea after seven days of treatment and a positive C. difficile toxin stool test as identified by the enzyme immunoassay. Only individuals who had not responded to metronidazole medication were included in our study. There were two groups created. For ten days, the intervention group was given 200 mg rifaximin pills three times a day. No new therapy was initiated for patients in the control group. The effectiveness of rifaximin was determined by the absence of diarrhea after two weeks of treatment and a negative stool test.

The key findings of this study were as follow:

1. The intervention group had a mean age of 45.41±8.54 years.

2. The bulk of the patients were between the ages of 35 and 50.

3. On presentation, the majority of the patients reported watery diarrhea, stomach cramps, and a lack of appetite.

4. Rifaximin was shown to be considerably beneficial in resolving CDI symptoms that had previously been resistant to metronidazole (p0.00001).

5. More than three weeks of diarrhea was observed to be substantially linked with therapeutic failure (p=0.03).

In conclusion, finally, rifaximin medication was shown to be very beneficial in the remission of CDI symptoms that were resistant to metronidazole therapy. Furthermore, researchers discovered that diarrhea lasting more than three weeks was substantially related to therapeutic failure. More large-scale investigations are needed to substantiate the assertion that rifaximin is effective in totally treating Clostridium infections resistant to standard treatment.

Reference:

Waqas M, Mohib K, Saleem A, et al. (April 14, 2022) Rifaximin Therapy for Patients With Metronidazole-Unresponsive Clostridium difficile Infection. Cureus 14(4): e24140. doi:10.7759/cureus.24140