The goal of this clinical trial is to learn how rifaximin 200 mg is processed in the body (pharmacokinetics) in children 6 to 11 years old with acute diarrhea that may be caused by bacteria. It will also learn about the safety and effectiveness of rifaximin when given with oral rehydration therapy (ORT) compared with ORT alone. The main questions it aims to answer are: How does rifaximin 200 mg move through and leave the body in children with acute diarrhea? Is rifaximin safe for children in this age group? Does rifaximin plus ORT help resolve diarrhea faster than ORT alone? Researchers will compare rifaximin plus ORT to ORT alone to see if adding rifaximin improves outcomes. Participants will: Take one rifaximin 200 mg tablet + ORT three times a day for 3 days or receive ORT alone Receive oral rehydration therapy according to the investigator's standard of care Attend up to 4 clinic visits over 5 days and receive 4 follow-up phone calls Provide blood samples on Day 1 and Day 3 for pharmacokinetic testing (rifaximin group only) Provide stool samples to identify bacterial pathogens Keep a diary of stool frequency and consistency to help determine when diarrhea resolves Be monitored for side effects, vital signs, and laboratory changes
This study is a randomized, open-label clinical trial designed to evaluate the pharmacokinetics, safety, and efficacy of rifaximin 200 mg in pediatric participants aged 6 to 11 years with acute diarrhea of suspected bacterial etiology. Acute diarrhea may be caused by bacterial infections such as E. coli, Shigella, Salmonella, or Campylobacter. Participants are randomly assigned to receive either rifaximin 200 mg plus oral rehydration therapy (ORT) or ORT alone. Participants in the rifaximin group take one tablet three times a day for 3 days, in addition to ORT according to the investigator's standard of care. Participants in the ORT-alone group receive ORT only. The primary objective is to assess how rifaximin is absorbed, distributed, and eliminated in children (pharmacokinetics). Secondary objectives include evaluating the safety and tolerability of rifaximin and assessing whether rifaximin plus ORT helps resolve diarrhea faster than ORT alone. Safety assessments include monitoring adverse events, vital signs, and laboratory tests (hematology, chemistry, and urinalysis). Participants or their caregivers keep a daily diary to record stool frequency and consistency, time to last unformed stool, and any related symptoms such as abdominal cramps, nausea, vomiting, or flatulence. Stool samples are collected to identify the bacterial pathogen(s) causing diarrhea. Pharmacokinetic assessments are conducted in participants receiving rifaximin plus ORT, with blood samples collected on Day 1 and Day 3: pre-dose, 1 hour post-dose, and 8 hours post-dose. Plasma samples are analyzed for rifaximin and 25-desacetyl rifaximin to determine pharmacokinetic parameters, including maximum concentration (Cmax), time to maximum concentration (Tmax), and area under the concentration-time curve (AUC). Participants attend up to four clinic visits over the 5-day study period and receive follow-up phone calls on Days 6, 7, 8, and 30 to monitor safety and collect diary information. Compliance with study drug and ORT administration is assessed throughout the study. This study is designed to provide information on rifaximin pharmacokinetics, its safety in children, and the potential benefit of rifaximin plus ORT in resolving acute diarrhea of suspected bacterial origin.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
54
Participants receive rifaximin 200 mg tablets orally three times daily (TID) for 3 days in combination with oral rehydration therapy (ORT). Blood samples for pharmacokinetic analysis are collected on Day 1 and Day 3 at pre-dose, 1 hour post-dose, and 8 hours post-dose.
Participants receive oral rehydration solution according to the investigator's standard of care. This is administered either alone (for the ORT-alone arm) or in combination with rifaximin (for the rifaximin + ORT arm). Participants or caregivers complete a daily diary documenting stool frequency, stool consistency, and related symptoms.
Peak Plasma Concentration (Cmax) of Rifaximin
Cmax levels following rifaximin 200 mg + ORT
Time frame: Days 1 and 3
Time to Maximum Plasma Concentration (Tmax) of Rifaximin
Tmax for rifaximin following rifaximin 200 mg + ORT
Time frame: Days 1 and 3
Area Under the Plasma Concentration-Time Curve From Time 0 to Last Quantifiable Concentration (AUC0-last) for Rifaximin
Area under the concentration-time curve to last measurable concentration
Time frame: Days 1 and 3
Area Under the Plasma Concentration-Time Curve Over the Dosing Interval (AUC0-τ) for Rifaximin
Area under the concentration-time curve over the dosing interval
Time frame: Days 1 and 3
Proportion of participants with Clinical Cure
Proportion of participants achieving clinical cure, defined as either: 1. No unformed stools within a 48-hour period with no fever (with or without other clinical symptoms such as abdominal cramps or pain, excess gas/flatulence, nausea, vomiting, urgency, tenesmus); or 2. No watery stools and no more than two soft stools within a 24-hour period with no fever and no other clinical symptoms except for mild excess gas/flatulence.
Time frame: Up to Day 5 (End of Treatment)
Time to Last Unformed Stool (TLUS)
Time in hours from the first dose of study treatment to the last unformed stool, after which clinical cure is declared, based on subject/caregiver diary entries.
Time frame: Up to Day 5 (End of Treatment)
Incidence of Treatment-Emergent Adverse Events (AEs)
Number and percentage of participants with AEs and SAEs
Time frame: Day 1-30
Change From Baseline in Clinical Laboratory Parameters
Changes in hematology, chemistry, and urinalysis values
Time frame: Day 1-30
Change From Baseline in Vital Signs
Change in temperature, blood pressure, and pulse
Time frame: Day 1-30
John Lahey VP, Clinical Operations
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