Effectiveness of rifaximin and fluoroquinolones in preventing travelers' diarrhea (TD): A systematic review and meta-analysis

被引：27

作者：

Alajbegovic S. ^{[1
]}

Sanders J.W. ^{[2
]}

Atherly D.E. ^{[3
]}

Riddle M.S. ^{[2
]}

机构：

[1] School of Pharmacy, University of Washington, Seattle, WA

[2] Naval Medical Research Center, Silver Spring

[3] PATH, Seattle, WA

来源：

Systematic Reviews | / 1卷 / 1期

关键词：

Chemoprophylaxis; Fluoroquinolone; Meta-analysis; Rifaximin; Systematic review; Travelers' diarrhea;

D O I：

10.1186/2046-4053-1-39

中图分类号：

学科分类号：

摘要：

Background: Recent developments related to a safe and effective nonabsorbable antibiotic, rifaximin, and identification of postinfectious irritable bowel syndrome as a frequent sequela call for a need to reconsider the value of primary prevention of traveler's diarrhea (TD) with antibiotics.Methods: Randomized, placebo-controlled, double-blind studies evaluating the effectiveness and safety of rifaximin or a fluoroquinolone chemoprophylaxis against TD were pooled using a random effects model and assessed for heterogeneity.Results: The nine studies (four rifaximin and five fluoroquinolone) included resulted in pooled relative risk estimates of 0.33 (95% CI = 0.24-0.45, I2 = 3.1%) and 0.12 (95% CI = 0.07-0.20, I2 =0.0%), respectively. Similar rates of treatment emergent adverse events were found between antibiotic and placebo groups.Conclusions: This meta-analysis supports the effectiveness of antibiotics in preventing TD. However, further studies that include prevention of secondary chronic health outcomes among travelers to different geographic regions, and a formal risk-benefit analysis for antibiotic chemoprophylaxis, are needed. © 2012 Alajbegovic et al.; licensee BioMed Central Ltd.

引用

共 50 条

[1]

Shah N., DuPont H.L., Ramsey D.J., Global etiology of travelers' diarrhea: systematic review from 1973 to the present, Am J Trop Med Hyg, 80, pp. 609-614, (2009)

[2]

Riddle M.S., Halvorson H.A., Shiau D., Althoff J., Monteville M.R., Shaheen H., Horvath E.P., Armstrong A.W., Acute gastrointestinal infection, respiratory illness, and noncombat injury among US military personnel during Operation Bright Star 2005, in Northern Egypt, J Travel Med, 14, pp. 392-401, (2007)

[3]

Shlim D.R., Looking for evidence that personal hygiene precautions prevent traveler's diarrhea, Clin Infect Dis, 41, SUPPL. 8, (2005)

[4]

Heywood A.E., Zhang M., MacIntyre C.R., Seale H., Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia, BMC Infect Dis, 12, (2012)

[5]

Yanni E.A., Marano N., Han P., Edelson P.J., Blumensaadt S., Becker M., Dwyer S., Crocker K., Daley T., Davis X., Gallagher N., Balaban V., McCarron M., Mounts A., Lipman H., Brown C., Kozarsky P., Knowledge, attitudes, and practices of US travelers to Asia regarding seasonal influenza and H5N1 avian influenza prevention measures, J Travel Med, 17, pp. 374-381, (2010)

[6]

Namikawa K., Iida T., Ouchi K., Kimura M., Knowledge, attitudes, and practices of Japanese travelers on infectious disease risks and immunization uptake, J Travel Med, 17, pp. 171-175, (2010)

[7]

Hartjes L.B., Baumann L.C., Henriques J.B., Travel health risk perceptions and prevention behaviors of US study abroad students, J Travel Med, 16, pp. 338-343, (2009)

[8]

Steffen R., Connor B.A., Vaccines in travel health: from risk assessment to priorities, J Travel Med, 12, pp. 26-35, (2005)

[9]

Travelers' diarrhea, JAMA, 253, pp. 2700-2704, (1985)

[10]

Reves R.R., Johnson P.C., Ericsson C.D., DuPont H.L., A cost-effectiveness comparison of the use of antimicrobial agents for treatment or prophylaxis of travelers' diarrhea, Arch Intern Med, 148, pp. 2421-2427, (1988)

← 1 2 3 4 5 →