Zusammenfassung
Seit 2 Jahren ist in Deutschland Rifaximin als darmselektives Breitbandantibiotikum zur Behandlung der durch nicht invasive enteropathogene Bakterien verursachten Reisediarrhö verfügbar. Aufgrund der guten Verträglichkeit und der hohen Wirksamkeit gegen darmpathogene Erreger wird ein hohes Zukunftspotenzial dieses seit mehr als 25 Jahren bekannten Arzneistoffs v. a. in weiteren Indikationsgebieten gesehen, die Gegenstand aktueller klinischer Untersuchungen sind. Dazu zählt die Behandlung der Divertikelerkrankung, der Clostridium-difficile-assoziierten Diarrhö und der pseudomembranösen Kolitis, der bakteriellen Fehlbesiedlung des Dünndarms, des Reizdarmsyndroms sowie der hepatischen Enzephalopathie. Diese Übersicht zeigt mögliche Einsatzgebiete in der Gastroenterologie auf und beurteilt kritisch den Stellenwert von Rifaximin in der Behandlung dieser Erkrankungen anhand neuester Daten.
Abstract
Rifaximin, a non-resorbable broadband antibiotic, was approved in Germany 2 years ago for the treatment of traveller’s diarrhoea caused by non-invasive enteropathogens. On account of the very good tolerance and the high efficacy against almost all enteropathogens this pharmaceutical, which has been available for 25 years, bears a high potential in many other indications which are currently under clinical investigations, including: symptomatic uncomplicated diverticular disease, Clostridium difficile-associated diarrhoea and pseudomembranous colitis, small bowel intestinal bacterial overgrowth, irritable bowel syndrome and hepathic encephalopathy. The present overview demonstrates potential indications in the field of gastroenterology and critically reviews the significance of rifiximin in the treatment of these diseases based on the latest clinica data.
Schlüsselwörter
bakterielle Fehlbesiedlung - Divertikulose - infektiöse Kolitis - Laktoseintoleranz - pseudomembranöse Kolitis - Colon irritabile
Key words
small bowel intestinal bacterial overgrowth - diverticular disease - infectious colitis - lactose intolerance - pseudomembranous colitis - irritable bowel syndrome
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Prof. Dr. Thomas Rabenstein
Innere Medizin und Gastroenterologie, Diakonissen-Stiftungs-Krankenhaus Speyer
Hilgradstraße 26
78346 Speyer
Telefon: ++ 49/62 32/22 18 83
Fax: ++ 49/62 32/22 18 58
eMail: thomas.rabenstein@diakonissen.de