XIFAXAN® is a broad spectrum antibiotic with low potential for clinically relevant resistance 1-4
Rifaximin-α inhibits bacterial RNA synthesis by irreversibly binding to the beta-subunit of the DNA-dependent RNA polymerase enzyme. 1 The gene encoding the bacterial DNA-dependent RNA polymerase is carried on chromosomal DNA, 3 meaning that to develop resistance to rifaximin-α, a mutation is required in the bacterial chromosomal DNA 3,4
Rifaximin-α acts locally in the gut, therefore no dose adjustment in hepatic insufficiency is required 1
- Some cases of development of Clostridium difficile strains resistant to rifaximin-α have been documented, however the incidence has been low in the studies published to date. 7,8
- In studies with repeated, high doses of rifaximin-α in healthy volunteers and Inflammatory Bowel Disease patients, strains resistant to rifaximin-α developed, but were unstable and did not colonise the gastrointestinal tract or replace rifaximin-α-sensitive strains. When treatment was discontinued, resistant strains disappeared rapidly 1