| Use of Oral Antibiotics in Elderly Gastrointestinal Patients |
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Seong Choon Choe, Dong Ho Lee |
1Executive Office, Hanall Biopharma, Seoul, Korea.
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. dhljohn@snubh.org
3Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. |
| 노인 소화기 환자에서 경구용 항생제의 사용 |
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최성준1, 이동호2, 3 |
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한올바이오파마 임원실1, 서울의대 내과학교실2, 분당서울대학교병원 소화기내과3 |
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| Abstract |
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Oral antibiotics are usually prescribed for geriatric patients for the treatment of infectious diarrhea and management of hepatic encephalopathy. But oral antibiotics have systemic adverse events, so many doctors face the issue of choosing the right antibiotics. Rifaximin, an intestinal topical antibiotic that exhibits a wide antimicrobial activity against both aerobic and anaerobic bacteria, has various indications, such as acute bacterial diarrhea caused by Gram positive and negative bacteria, traveler's diarrhea, small intestine bacterial overgrowth, prevention of infection after gastrointestinal surgery, and the management of hepatic encephalopathy with hyperammoniemia. But there are few clinical trial data on the geriatric population. Hence we reviewed the clinical study data that included geriatric patients in their clinical trials. Based on our literature searches, only one clinical trial on acute bacterial diarrhea was performed only for geriatric patients. Other clinical trials for various indications usually recruited elderly patients, but the number of elderly patients was limited. However, generally speaking, rifaximin showed good efficacy and safety profile in acute bacterial diarrhea caused by Gram positive and negative bacteria, traveler's diarrhea, small intestine bacterial overgrowth, prevention of infection after gastrointestinal surgery, and the management of hepatic encephalopathy with hyperammoniemia; and there were no differences in efficacy and safety, compared to the nongeriatric population. We concluded that rifaximin is a good therapeutic option for various gastrointestinal indications, and shows good efficacy and an excellent safety profile, compared to other oral agents. For more evidence on the geriatric population, we propose clinical trials on elderly patients for each indication. |
| Key Words:
Antibiotics, Rifaximin, Traveler's diarrhea, Hepatic encephalopathy |
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