Rifaximin seems to break the vicious cycle of relapse in some patients.
Clostridium difficile–associated diarrhea (CDAD) recurs after initial therapy in up to 50% of patients, and an unlucky few suffer multiple relapses. Treatments including prolonged antibiotic courses, antibiotic combinations, probiotic regimens, and even infusions of “healthy” stool to recolonize the gut have been effective in some patients. Researchers now report promising preliminary data on a simpler alternative.
Eight patients who had experienced four to eight episodes of CDAD within the previous year were treated with a 2-week “chaser” course of the oral nonabsorbable rifampin analog rifaximin, immediately after completing a course of vancomycin for relapsed CDAD. All patients were asymptomatic when beginning rifaximin and remained asymp…