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世界核心医学期刊文摘（胃肠病学分册） 2005年第9期1卷 2-3页

作者： Dupont H.L. okhuysen p.c. 刘丽娜 Mc 1-164 6720 Bertner Avenue Houston TX 77030 United States Dr.

Background: Travelersdiarrhea causes substantial morbidity and postinfectiou s irritable bowel syndrome. Objective: To evaluate nonabsorbable rifaximin for p revention of travelersdiarrhea. Design: Randomized, doubleblind, placeboco ntrolled clinical trial. Setting:Guadalajara, Me xico. participants: U.S. students. Intervention: On arrival in Guadalajara, Me xico, 210 U.S. adults received rifaximin (200 mg/d, 200 mg twice daily, or 200 m g 3 times daily) or placebo for 2 weeks. Measurements: participants were followe d daily for 3 weeks for enteric disease and symptoms and daily for 5 weeks for d rug side effects. changes in intestinal coliform flora were studied. Results: Tr avelersdiarrhea developed in 14.74%of participants taking rifaximin and 53.70 %of those taking placebo (rate ratio, 0.27 [95%cI, 0.17 to 0.43]). Rifaximin p rovided 72%and 77%protection against travelersdiarrhea and antibiotictreat ed travelersdiarrhea, resp.c.ively (pperior to placebo. In the groups that did not report travelersdiarrhe a, rifaximin significantly reduced the occurrence of mild diarrhea (p = 0.02) an d moderate and severe intestinal problems (p = 0.009 for pain or cramps; p = 0.0 2 for excessive gas). Rates of adverse events were comparable in the rifaximin a nd placebo groups. Minimal changes in coliform flora were found during rifaximin therapy. Limitations: Rifaximin safely prevented travelersdiarrhea in Mexico, where most cases are caused by diarrheaproduc ing Escherichia coli. A study is needed in Asia to determine whether rifaximin can prevent diarrhea caused by invasive bacterial pathogens. conclusions: Rifax imin prevents travelersdiarrhea with minimal changes in fecal flora, and more liberal chemoprophylaxis against this disease should be considered. Future studi es should evaluate whether rifaximin is effective in preventing postinfectious i rritable bowel syndrome.

关键词：利福昔明旅行者安慰剂对照肠易激综合征大肠埃希杆菌属瓜达拉哈拉美国成人侵袭性美国大学生轻度腹泻

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