medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-5-167-174medsovet-6183Research ArticleЗАБОЛЕВАНИЯ КИШЕЧНИКАBOWEL DISEASESРифаксимин: уникальный селективный антибиотик для лечения желудочно-кишечных заболеванийRifaximin: unique selective antibiotic for the treatment of gastrointestinal diseaseshttps://orcid.org/0000-0002-6150-1808ПлотниковаЕ. Ю.PlotnikovaE. Yu.

д.м.н., профессор кафедры поликлинической терапии, постдипломной подготовки врачей и сестринского дела, руководитель курса клинической гастроэнтерологии, 

650022, Кемерово, ул. Ворошилова, д. 22а

Dr. of Sci. (Med.), Professor of the Department of Polyclinic Therapy, Postgraduate training of doctors and nursing, Head of the Clinical Gastroenterology Course, 

22a, Voroshilov St., Kemerovo, 650029

eka-pl@rambler.ruКемеровский государственный медицинский университетРоссияKemerovo State Medical UniversityRussian Federation20211305202105167174Copyright © Плотникова Е.Ю., 20212021Плотникова Е.Ю.Plotnikova E.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6183

Микробиота кишечника человека была главной целью научных исследований в последние годы. Исследования, основанные на  метагеномных методах, выявили многогранные способности кишечных микробов  – от  метаболических функций до иммуномодуляции, от антипатогенной активности до формирования поведения. Поскольку микробиота кишечника играет решающую роль в  поддержании здоровья человека, с  различными желудочно-кишечными заболеваниями связаны более или менее специфические изменения микробиоты кишечника. Эти данные убедительно подтверждают использование модуляторов кишечной микробиоты, таких как антибиотики, пребиотики и пробиотики, в качестве выбора при почти всех желудочно-кишечных расстройствах. Традиционное использование антибиотиков в клинической практике заключается в  противодействии местным или системным инфекциям. Можно предположить пагубное влияние антибиотиков на кишечную экологию. Однако это не относится ко всем антибиотикам.

Рифаксимин представляет собой несистемный пероральный антибиотик, полученный из рифампина и характеризующийся широким спектром антибактериальной активности в отношении грамположительных и отрицательных, аэробных и анаэробных бактерий. Рифаксимин был впервые одобрен в Италии в 1987 г., а затем во многих других странах мира для лечения ряда желудочно-кишечных заболеваний. В настоящем обзоре представлены фармакология и фармакодинамика рифаксимина, описываются различные действия, помимо его антибактериальной активности, такие как изменение вирулентности, предотвращение адгезии слизистой оболочки кишечника и бактериальной транслокации. Также описаны ключевые исследования по разным областям применения рифаксимина. Кроме того, рифаксимин оказывает некоторые противовоспалительные эффекты с минимальным влиянием на общий состав кишечной микробиоты. Все эти свойства делают рифаксимин хорошим кандидатом для лечения различных желудочно-кишечных заболеваний. 

The human gut microbiota has been a major focus of scientific research in recent years. Studies based on metagenomic methods have revealed the multifaceted abilities of gut microbes, from metabolic functions to immunomodulation, from antipathogenic activity to behavioral formation. Since the gut microbiota plays a crucial role in maintaining human health, more or less specific changes in the gut microbiota are associated with various gastrointestinal diseases. These data strongly support the use of gut microbiota modulators, such as antibiotics, prebiotics and probiotics, as the choice for almost all gastrointestinal disorders. The traditional use of antibiotics in clinical practice is to counteract local or systemic infections. It can be assumed that antibiotics have a detrimental effect on the intestinal ecology. However, this is not true for all antibiotics.

Rifaximin is a non-systemic oral antibiotic derived from rifampin and is characterized by a broad spectrum of antibacterial activity against Gram-positive and negative, aerobic and anaerobic bacteria. Rifaximin was first approved in Italy in 1987 and then in many other countries of the world for the treatment of several gastrointestinal diseases. This review presents the pharmacology and pharmacodynamics of rifaximin, describing various actions beyond its antibacterial activity, such as altering virulence, preventing intestinal mucosal adhesion and bacterial translocation. Key studies on the different uses of rifaximin are also described. In addition, rifaximin has some anti-inflammatory effects with minimal impact on the overall composition of the gut microbiota. All of these properties make rifaximin a good candidate for the treatment of various gastrointestinal diseases.

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The authors declare that there are no conflicts of interest present.