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Рифаксимин: уникальный селективный антибиотик для лечения желудочно-кишечных заболеваний

https://doi.org/10.21518/2079-701X-2021-5-167-174

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Аннотация

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. 

Об авторе

Е. Ю. Плотникова
Кемеровский государственный медицинский университет
Россия

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

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



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Для цитирования:


Плотникова Е.Ю. Рифаксимин: уникальный селективный антибиотик для лечения желудочно-кишечных заболеваний. Медицинский Совет. 2021;(5):167-174. https://doi.org/10.21518/2079-701X-2021-5-167-174

For citation:


Plotnikova E.Yu. Rifaximin: unique selective antibiotic for the treatment of gastrointestinal diseases. Meditsinskiy sovet = Medical Council. 2021;(5):167-174. (In Russ.) https://doi.org/10.21518/2079-701X-2021-5-167-174

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