Herbert L. DuPont, MD; Zhi-Dong Jiang, PhD; Pablo C. Okhuysen, MD; Charles D. Ericsson, MD; Francisco Javier de la Cabada, MD; Shi Ke, MD; Margaret W. DuPont, MA; Francisco Martinez-Sandoval, MD, PhD
Presented at Digestive Diseases Week, New Orleans, Louisiana, 16 May 2004.
Acknowledgments: The authors acknowledge the valuable contributions of several colleagues. The field research team was composed of Dorothy Ruelas, RN; Sylvia Vaca, RN; Carmen Pulido; Mathew Cherno; David Hamilton; Elizabeth Juarez; Shelby Melton; Sean Pawlowski; and Courtney Ramirez. Directors of the participating schools at the Guadalajara Summer Programs of the University of Arizona and the University of San Diego were Drs. Macario Saldate and Carl Jubran. Robert Haake and Mary Sarah Baraniuk provided statistical advice on the study, and Dr. David N. Taylor provided editorial help.
Grant Support: By Salix Pharmaceuticals; the Vaccine and Treatment Evaluation Unit Enteric Challenge Studies (NO1-AI-25465); and Public Health Service grant DK 56338, which funds the Texas Gulf Coast Digestive Diseases Center.
Potential Financial Conflicts of Interest: Consultancies: H.L. DuPont (Salix Pharmaceuticals), P.C. Okhuysen (Abbott Laboratories, Aventis, Bristol-Myers Squibb, Cubist, Merck, Pfizer, Salix Pharmaceuticals, Trimeris), C.D. Ericsson (Salix Pharmaceuticals); Honoraria: H.L. DuPont (Salix Pharmaceuticals), P.C. Okhuysen (Abbott Laboratories, Aventis, Bristol-Myers Squibb, Cubist, Merck, Pfizer, Salix Pharmaceuticals, Trimeris), C.D. Ericsson (Salix Pharmaceuticals); Grants received: H.L. DuPont (Salix Pharmaceuticals), C.D. Ericsson (Salix Pharmaceuticals).
Requests for Single Reprints: Herbert L. DuPont, MD, 6720 Bertner Avenue, MC 1-164, Houston, TX 77030; e-mail, email@example.com.
Current Author Addresses: Dr. DuPont: 6720 Bertner Avenue, MC 1-164, Houston, TX 77030.
Dr. Jiang: University of Texas–Houston School of Public Health, 1200 Herman Pressler, Houston, TX 77030.
Dr. Okhuysen: Division of Infectious Diseases, University of Texas– Houston Health Science Center, 6431 Fannin Street, JFB 1.728, Houston, TX 77030.
Dr. Ericsson: University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77050.
Dr. de la Cabada: Avenida "C", 630K, Col. Seattle Zapopan, Jalisco CP 45150, Mexico.
Dr. Ke: University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030.
Ms. DuPont: 1111 Herman Drive, 19F, Houston, TX 77004.
Dr. Martinez-Sandoval: Universidad Autonoma de Guadalajara, Apartado Postal 1-440, Guadalajara, Jalisco 45110, Mexico.
Author Contributions: Conception and design: H.L. DuPont, Z.-D. Jiang, C.D. Ericsson, S. Ke, F. Martinez-Sandoval.
Analysis and interpretation of the data: H.L DuPont, Z.-D. Jiang, P.C. Okhuysen, C.D. Ericsson, S. Ke.
Drafting of the article: H.L. DuPont.
Critical revision of the article for important intellectual content: H.L. DuPont, Z.-D. Jiang, P.C. Okhuysen, C.D. Ericsson, S. Ke.
Final approval of the article: H.L. DuPont, Z.-D. Jiang.
Provision of study materials or patients: H.L. DuPont, P.C. Okhuysen, C.D. Ericsson, F.J. de la Cabada, F. Martinez-Sandoval.
Statistical expertise: H.L. DuPont, Z.-D. Jiang, S. Ke.
Obtaining of funding: H.L. DuPont.
Administrative, technical, or logistic support: H.L. DuPont, Z.-D. Jiang, P.C. Okhuysen, C.D. Ericsson, M.W. DuPont.
Collection and assembly of data: H.L. DuPont, Z.-D. Jiang, P.C. Okhuysen, F.J. de la Cabada, M.W. DuPont, F. Martinez-Sandoval.
DuPont HL, Jiang Z, Okhuysen PC, Ericsson CD, de la Cabada FJ, Ke S, et al. A Randomized, Double-Blind, Placebo-Controlled Trial of Rifaximin To Prevent Travelers' Diarrhea. Ann Intern Med. 2005;142:805-812. doi: 10.7326/0003-4819-142-10-200505170-00005
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Published: Ann Intern Med. 2005;142(10):805-812.
Using absorbed antibiotics to prevent travelers' diarrhea is costly, has side effects, and promotes resistant organisms. Rifaximin is a nonabsorbed antibiotic approved for treating travelers' diarrhea. Its effectiveness in preventing the condition is unknown.
In this randomized trial, 210 adults who were newly arrived in Guadalajara, Mexico, took 1 of 3 dosages of rifaximin or placebo for 2 weeks. The rate of travelers' diarrhea was 53.70% in the placebo group and 14.74% in the treated groups. Treatment caused minimal changes in fecal flora.
It is uncertain whether these findings are generalizable to geographic areas where Escherichia coli is not the major pathogen.
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