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.
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[21]  
DuPont H.L., Travellers' diarrhoea: contemporary approaches to therapy and prevention, Drugs, 66, pp. 303-314, (2006)
[22]  
Chapman A.S., Witkop C.T., Escobar J.D., Schlorman C.A., DeMarcus L.S., Marmer L.M., Crum M.E., Norovirus outbreak associated with person-to-person transmission, U.S. Air Force Academy, July 2011, MSMR, 18, pp. 2-5, (2011)
[23]  
Harbord R.M., Egger M., Sterne J.A., A modified test for small-study effects in meta-analyses of controlled trials with binary endpoints, Stat Med, 25, pp. 3443-3457, (2006)
[24]  
Johnson P.C., Ericsson C.D., Morgan D.R., Dupont H.L., Cabada F.J., Lack of emergence of resistant fecal flora during successful prophylaxis of traveler's diarrhea with norfloxacin, Antimicrob Agents Chemother, 30, pp. 671-674, (1986)
[25]  
Cohen D., Shoham O., Orr N., Muhsen K., An inverse and independent association between Helicobacter pylori infection and the incidence of shigellosis and other diarrheal diseases, Clin Infect Dis, 54, (2012)
[26]  
DuPont H.L., Jiang Z.D., Okhuysen P.C., Ericsson C.D., de la Cabada F.J., Ke S., DuPont M.W., Martinez-Sandoval F., A randomized, double-blind, placebo-controlled trial of rifaximin to prevent travelers' diarrhea, Ann Intern Med, 142, pp. 805-812, (2005)
[27]  
Flores J., DuPont H.L., Jiang Z.D., Okhuysen P.C., Melendez-Romero J.H., Gonzalez-Estrada A., Carrillo I., Paredes M., A randomized, double-blind, pilot study of rifaximin 550 mg versus placebo in the prevention of travelers' diarrhea in Mexico during the dry season, J Travel Med, 18, pp. 333-336, (2011)
[28]  
Martinez-Sandoval F., Ericsson C.D., Jiang Z.D., Okhuysen P.C., Romero J.H., Hernandez N., Forbes W.P., Shaw A., Bortey E., DuPont H.L., Prevention of travelers' diarrhea with rifaximin in US travelers to Mexico, J Travel Med, 17, pp. 111-117, (2010)
[29]  
Parry H., Howard A.J., Galpin O.P., Hassan S.P., The prophylaxis of travellers' diarrhoea: a double blind placebo controlled trial of ciprofloxacin during a Himalayan expedition, J Infect, 28, pp. 337-338, (1994)
[30]  
Rademaker C.M., Hoepelman I.M., Wolfhagen M.J., Beumer H., Rozenberg-Arska M., Verhoef J., Results of a double-blind placebo-controlled study using ciprofloxacin for prevention of travelers' diarrhea, Eur J Clin Microbiol Infect Dis, 8, pp. 690-694, (1989)
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