Antimotility agents provide rapid temporary relief of acute diarrhea, whereas antibiotics slowly cure the illness.
Thus, the combination of an antimotility agent and an antibiotic may provide greater therapeutic benefit than either drug alone.
Dr Herbert DuPont and colleagues from Texas evaluated the efficacy and safety of rifaximin-loperamide in the treatment of travelers' diarrhea.
|Unformed stools were lower with combination therapy|
|Clinical Gastroenterology & Hepatology|
The team randomized consenting adults with acute diarrhea to receive rifaximin 200 mg 3 times daily for 3 days.
Acute diarrhea was defined as 3 unformed stools in 24 hours with at least 1 symptom of enteric infection.
Loperamide 4 mg initially followed by 2 mg after each unformed stool, or a combination of both drugs using the same dosing regimen was given.
The primary end point was the median time from beginning therapy until passing the last unformed stool.
The researcher reported that a total of 310 patients completed treatment.
The team randomized 102 patients to rifaximin, 104 to loperamide, or 104 to rifaximin-loperamide combination therapy.
The groups showed demographic similarity.
The team found that rifaximin and rifaximin-loperamide significantly reduced the median time until passage of the last unformed stool vs loperamide.
The mean number of unformed stools passed during illness was lower with rifaximin-loperamide compared with rifaximin or loperamide alone.
The team observed that all treatments were well tolerated with a low incidence of adverse events.
Dr DuPont's team concluded, "Rifaximin-loperamide therapy provided rapid symptomatic improvement and greater overall wellness compared with either agent alone."