%0 Journal Article
%T Effectiveness of rifaximin and fluoroquinolones in preventing travelersĄ¯ diarrhea (TD): a systematic review and meta-analysis
%A Alajbegovic Sanjin
%A Sanders John W
%A Atherly Deborah E
%A Riddle Mark S
%J Systematic Reviews
%D 2012
%I BioMed Central
%R 10.1186/2046-4053-1-39
%X Background Recent developments related to a safe and effective nonabsorbable antibiotic, rifaximin, and identification of postinfectious irritable bowel syndrome as a frequent sequela call for a need to reconsider the value of primary prevention of travelerĄ¯s diarrhea (TD) with antibiotics. Methods Randomized, placebo-controlled, double-blind studies evaluating the effectiveness and safety of rifaximin or a fluoroquinolone chemoprophylaxis against TD were pooled using a random effects model and assessed for heterogeneity. Results The nine studies (four rifaximin and five fluoroquinolone) included resulted in pooled relative risk estimates of 0.33 (95% CI = 0.24¨C0.45, I2 = 3.1%) and 0.12 (95% CI = 0.07¨C0.20, I2 =0.0%), respectively. Similar rates of treatment emergent adverse events were found between antibiotic and placebo groups. Conclusions This meta-analysis supports the effectiveness of antibiotics in preventing TD. However, further studies that include prevention of secondary chronic health outcomes among travelers to different geographic regions, and a formal risk-benefit analysis for antibiotic chemoprophylaxis, are needed.
%K TravelersĄ¯ diarrhea
%K Chemoprophylaxis
%K Systematic review
%K Meta-analysis
%K Rifaximin
%K Fluoroquinolone
%U http://www.systematicreviewsjournal.com/content/1/1/39