antibioticsАнтибиотики и ХимиотерапияAntibiot Khimioter = Antibiotics and Chemotherapy0235-2990ООО «Издательство ОКИ»10.37489/0235-2990-2020-65-7-8-52-62antibiotics-754Research ArticleОБЗОРЫREVIEWSРифаксимин-альфа и другие кристаллические формы рифаксимина: есть ли отличия?Rifaximin-Alpha and Other Crystalline Forms of Rifaximin: Are There Any Differences?ЗыряновС. К.ZyryanovS. K.

Зырянов Сергей Кенсаринович - д. м. н., профессор, зав. кафедрой общей и клинической фармакологии

 Москва

Moscow

БайбулатоваЕ. А.BaybulatovaE. A.

Байбулатова Елена Александровна - к. м. н., ассистент кафедры общей и клинической фармакологии

Москва

Moscow

ФГАОУ ВО «Российский университет дружбы народов»РоссияRUDN UniversityRussian Federation202021112020657-85262Copyright © ООО «Издательство ОКИ», 20202020ООО «Издательство ОКИ»ООО «Издательство ОКИ»https://www.antibiotics-chemotherapy.ru/jour/about/submissions#copyrightNoticehttps://www.antibiotics-chemotherapy.ru/jour/article/view/754

Рифаксимин - антибиотик, для которого характерен полиморфизм. У рифаксимина существуют различные кристаллические формы с разными фармакологическими характеристиками. Рифаксимин действует локально в пищеварительном тракте, поэтому важно, чтобы его абсорбция была минимальной, а концентрация в просвете кишечника высокой. Абсорбция в кишечнике других кристаллических форм рифаксимина более значима по сравнению с рифаксимином-α (Альфа Нормикс®). Различия в фармакокинетике кристаллических форм рифаксимина могут влиять на его эффективность и безопасность, особенно у пациентов с хроническими заболеваниями (состояние иммунодефицита и в условиях «leaky gut» на фоне цирроза печени), которым требуются длительные курсы терапии. Рифаксимин-α (Альфа Нормикс®) обладает уникальным действием, так как кроме местного антибактериального действия демонстрирует эубиотический эффект и обладает противовоспалительными свойствами. Учитывая разнообразные механизмы действия, рифаксимин-α положительным образом модулирует микробиоту кишечника.

Rifaximin is an antibiotic characterized by polymorphism. It has various crystalline forms with different pharmacological characteristics. Rifaximin acts locally in the digestive tract, therefore it is important for the absorption to be minimal and for concentration in the intestinal lumen to be high. The absorption of other crystalline forms of rifaximin in the intestine is greater than that of rifaximin-α (Alpha Normix®). Differences in pharmacokinetics of the crystalline forms of rifaximin may affect its effectiveness and safety, especially in patients with chronic diseases (immunodeficiency and leaky gut against the background of liver cirrhosis) who require long courses of therapy. Rifaximin-α (Alpha Normix®) is unique as it has eubiotic and anti-inflammatory properties in addition to local antibacterial effect. Given its diverse mechanisms of action, rifaximin-α positively modulates gut microbiota.

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