Comparative Pharmacology
Head-to-head clinical analysis: CHLORAMPHENICOL versus XIFAXAN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CHLORAMPHENICOL versus XIFAXAN.
CHLORAMPHENICOL vs XIFAXAN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing peptide bond formation.
Rifaximin is a non-systemic, gut-selective antibiotic that inhibits bacterial RNA synthesis by binding to the beta-subunit of bacterial DNA-dependent RNA polymerase, thereby reducing bacterial overgrowth and altering gut microbiota composition.
50-100 mg/kg/day IV divided every 6 hours (not to exceed 4 g/day); for susceptible severe infections, 12.5-25 mg/kg IV every 6 hours.
550 mg orally twice daily for traveler's diarrhea; 550 mg orally three times daily for hepatic encephalopathy.
None Documented
None Documented
1.5-4.0 hours in adults; prolonged to 3-7 hours in neonates and up to 24 hours in severe hepatic impairment
Clinical Note
moderateChloramphenicol + Fluconazole
"The metabolism of Fluconazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Ketoconazole
"The metabolism of Ketoconazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Ticlopidine
The terminal elimination half-life for rifaximin after oral administration ranges from 1.8 to 10 hours, with a mean of approximately 6 hours. The half-life is extended in hepatic impairment due to reduced clearance, and no dosage adjustment is recommended for renal impairment.
~90% renal (5-10% unchanged; remainder as inactive glucuronide), ~10% biliary/fecal
Rifaximin is primarily eliminated unchanged in feces via biliary excretion (approximately 97% of an oral dose). Renal excretion of unchanged drug accounts for <0.4% of the dose. Fecal elimination is the major route.
Category D/X
Category C
Antibiotic
Antibiotic
"The metabolism of Ticlopidine can be decreased when combined with Chloramphenicol."