HEALTH & SCIENCE

New antibiotic may thwart travelers' tummy troubles

Many experts are cautious about the possible consequences of widespread use.

By Victoria Stagg Elliott, AMNews staff. June 20, 2005.

Prescribing a newer antibiotic that only acts in the gut may prevent cases of the dreaded diarrhea that frequently strikes people who travel to less-developed countries -- and it might achieve this end without the adverse events associated with broader-spectrum drugs, according to a study published in the May 17 Annals of Internal Medicine.

"It's very effective," said Herbert L. DuPont, MD, lead author and chief of internal medicine at St. Luke's Episcopal Hospital in Houston. "And there are no reported side effects."

Researchers randomized 210 American students attending a course in Guadalajara, Mexico, to receive, beginning upon arrival, two weeks of twice-daily doses of rifaximin, three-daily doses or a placebo. Rifaximin is a nonabsorbable antibiotic approved by the Food and Drug Administration in May 2004 for treatment of travelers' diarrhea.

Overall, only about 15% of those who took it developed symptoms, while about 54% in the placebo arm did. Also, those who took the medication and did not develop travelers' diarrhea were less likely to have other related intestinal problems, and any such complaints tended to be more mild. The conclusion: This drug may be a good choice for prevention as well as treatment.

"It would be wonderful to be able to use a nonabsorbable antibiotic that doesn't tend to interact with other medications and has a low side-effect profile for prophylaxis," said Phyllis Kozarsky, MD, professor of medicine and infectious disease at Emory University School of Medicine in Atlanta.

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