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Colegio de Medicina Interna de México.

2019, Número 6

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Med Int Mex 2019; 35 (6)


Rifaximina-alfa en el tratamiento de la enfermedad diverticular. Evidencia y conceptos actuales

García-Zermeño KR, Valdovinos-Díaz MÁ, Raña-Garibay R, Abreu AAT, Remes-Troche JM

Idioma: Español
Referencias bibliográficas: 60
Paginas: 912-926
Archivo PDF: 553.27 Kb.


RESUMEN

La enfermedad diverticular o diverticulosis es una de las enfermedades digestivas más frecuentes en los países occidentales y esto se ha relacionado con múltiples factores, como el consumo de una dieta baja en fibra, el sedentarismo y el envejecimiento. El espectro de la enfermedad diverticular es amplio e incluye desde las formas asintomáticas (diverticulosis) hasta la existencia de complicaciones, como hemorragia, inflamación y perforación, pasando por formas intermedias, como la colitis segmentaria. Recientemente se describió que la disbiosis puede jugar un papel fundamental en la aparición de las complicaciones de la diverticulosis y al respecto se ha demostrado que la administración de moduladores eubióticos, específicamente la rifaximina, puede ser útil. La rifaximina es un antibiótico no absorbible con efectos eubióticos y antibóticos únicos en el tratamientos de los pacientes con enfermedad diverticular. La evidencia demuestra que la administración del polimorfo alfa de la rifaximina (rifaximina-alfa) en enfermedad diverticular no complicada solo o en asociación con fibra es segura y efectiva. Los datos disponibles de múltiples estudios reportan alivio significativo de los síntomás e incluso prevención de nuevos episodios de diverticulitis aguda, por lo que diferentes guías y consensos en todo el mundo consideran a rifaximina-alfa parte primordial en el tratamiento de la enfermedad diverticular. La eficacia, seguridad y tolerancia de otros polimorfos de la rifaximina diferentes a la alfa se desconocen, por lo que no es apropiado asumir similitud o equivalencia con base en los estudios en los que se evalúo la rifaximina-alfa.


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