Rifaximin versus ciprofloxacin for the treatment of traveler's diarrhea: Arandomized, double-blind clinical trial

Rifaximin is a poorly absorbed rifamycin derivative under investigation for treatment of infectious diarrhea. Adult students from the United States in Mexico and international tourists in Jamaica were randomized to receive ei ther rifaximin (400 mg twice per day) or ciprofloxacin (500 mg twice per da y) for 3 days, following a double-blinded model, from June 1997 to Septembe r 1998. A total of 187 subjects with diarrhea were studied. Time from initi ation of therapy to passage of last unformed stool was comparable for those receiving rifaximin or ciprofloxacin (median, 25.7 hours versus 25.0 hours , respectively). There was no significant difference in the proportion of s ubjects in the 2 groups with respect to clinical improvement during the fir st 24 hours (P=.199), failure to respond to treatment (P=.411), or microbio logical cure (P=.222). The incidence of adverse events was low and similar in each group. Rifaximin is a safe and effective alternative to ciprofloxac in in the treatment of traveler's diarrhea.