Tuesday, November 11, 2014

What I learnt in the last Pediatric Meeting - using Rifaximin in Indian Children - clinical pearl by Dr B R Thapa

I am just going to discuss a clinical pearl of wisdom that I learnt from Dr B R Thapa regarding using a relatively new antibiotic Rifaximin  (available in India as SIBOFIX - Dr Reddy's) during his talk in August 2014 at our Chandigarh quarterly meeting of Pediatricians from the tricity of Chandigarh Panchkula & Mohali.
When I asked him about when to use this particular antibiotic in children with diarrhea, here is what he said - as I understood it...

"In the monsoon months, there is a higher incidence of bacterial diarrhea due to water and food contamination, in India. hence if my clinical judgement I feel that the child is having a bacterial diarrhea - high fever, significant stomach pain, unwell look, then it may be possible to use Rifaximin. The benefits of using Rifaximin are that it is completely non-absorbable, hence the chances of side-effects are less, and it is very safe for kids (licensed above 2 years age at present in India). Also, there is little chance of antibiotic resistance developing given that there is no absorption in the body. Finally, since it stays in the body for a long time, ONLY three days of medicine is good enough to treat most infections"

I have been using this medicine in my practice after this discussion, and have found good results in diarrhea with possible bacterial infection.
I would be happy to know the experience of other pediatricians who have used this drug, especially in Indian children.
Just as an aside, Rifaximin is also recommended for use in cases of traveler's diarrhea, for people traveling across the world.
Please remember that this is just my opinion, and how I remember the conversation. Any errors are mine.

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