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Rifaximin intake leads to emergence of rifampin-resistant staphylococci

Thomas Valentin1, Eva Leitner, Angelika Rohn

  • 1Section of Infectious Diseases, Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 20, Graz, Austria.

The Journal of Infection
|November 16, 2010
PubMed
Abstract

Insights

Oral intake of rifaximin led to the emergence of rifampin-resistant staphylococci in healthy volunteers. This cross-resistance suggests rifaximin should be avoided in patients susceptible to staphylococcal infections.

Area of Science:

  • Microbiology
  • Pharmacology
  • Dermatology

Background:

  • Rifaximin is a non-systemic antibiotic for gastrointestinal issues.
  • Rifampin is crucial for staphylococcal infections, but resistance develops quickly.
  • Rifaximin's structural similarity to rifampin raises concerns about cross-resistance.

Purpose of the Study:

  • To investigate the emergence of rifampin-resistant staphylococci in human skin after oral rifaximin administration.
  • To assess potential cross-resistance between rifaximin and rifampin in skin staphylococci.

Main Methods:

  • Healthy volunteers were administered oral rifaximin.
  • Skin staphylococcal isolates were collected during and after rifaximin intake.
  • Rifampin resistance was determined using E-Test.

Main Results:

  • Rifampin-resistant staphylococci emerged in 7 of 11 volunteers post-rifaximin intake.
  • Eleven rifampin-resistant and three intermediate isolates were identified.
  • Resistant strains were initially found on perianal skin, later on hands and arms.

Conclusions:

  • Oral rifaximin intake can lead to the development of rifampin-resistant staphylococci.
  • Rifaximin use may pose a risk for patients with or at risk of staphylococcal foreign body infections.
  • Avoid rifaximin in patients susceptible to staphylococcal foreign body infections due to cross-resistance risk.

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