Annals of Internal Medicine, tip sheet, October 17, 2006

1. Antibiotic Gives Hope to Patients with IBS
   A new study found that patients reported greater global improvements in irritable bowel syndrome (IBS) symptoms and less bloating after taking rifaximin than patients taking a placebo. The randomized, double-blind study is the first to demonstrate a sustained benefit of antibiotics for IBS symptoms after treatment is stopped. In the study, 87 patients with IBS between the ages of 18 and 65 received rifaximin (an antibiotic that works only in the gut) or a placebo for 10 days. Patients reported their symptoms for the next 10 weeks. More than 50 percent improvement in symptoms was reported by more patients who took rifaximin (37.2 percent) than by those who took placebo (15 percent). However, the researchers did not detect a difference in symptoms of diarrhea or constipation. The researchers caution that while the study demonstrates improvement for a relatively small group of IBS patients, side effects may be difficult to assess in such a small study when considering the potentially large patient population with IBS. A larger and longer study is necessary to evaluate the effects of treatment for other symptoms, such as constipation.

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2. People Treated for Sexually Transmitted Infections Are at High Risk for Reinfection
   A study of 2,419 people treated for chlamydia, gonorrhea, or vaginosis (women only) at three urban STD clinics found that 25.8 percent of women and 14.7 percent of men became reinfected with one or more of the sexually transmitted infections within a year (Article, p. 564). Approximately 66 percent of reinfections were asymptomatic. New infection was more common among participants who had a new partner or had more than one partner. Black participants were at higher risk than those from other ethnic groups for recurrent infection and were at particularly high risk for vaginosis. Chlamydia and vaginosis infections also were more common among Hispanic participants and those of other races or ethnicities than among white participants. The researchers recommend that men and women diagnosed with chlamydia, gonorrhea, or vaginosis should return in three months for rescreening because they are at high risk for new asymptomatic sexually transmitted infections.

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