From the Research
Rifaximin dosing for pediatric patients should be individualized based on the specific indication, age, and weight of the child, with doses ranging from 10-30 mg/kg/day divided into 2-3 doses for 7-10 days for small intestinal bacterial overgrowth (SIBO), as supported by the most recent and highest quality study available 1.
Indications and Dosage
- For children with traveler's diarrhea (age 12 and older), the recommended dose is 200 mg three times daily for 3 days, similar to the adult regimen.
- For hepatic encephalopathy in pediatric patients, dosing typically ranges from 10-15 mg/kg/day divided into 2-3 doses, though this use is less established in children.
- For SIBO, doses of 10-30 mg/kg/day divided into 2-3 doses for 7-10 days are often used, adjusted based on the child's weight, as shown in a study where rifaximin 600 mg daily for one week was effective in treating SIBO in children with irritable bowel syndrome 1.
Safety and Tolerability
- Rifaximin is generally well-tolerated in children due to its minimal systemic absorption, with most of the drug remaining in the gastrointestinal tract where it exerts its antimicrobial effects against enteric bacteria.
- This localized action contributes to its favorable safety profile with limited side effects, typically including mild gastrointestinal symptoms such as abdominal pain, nausea, or flatulence, as reported in a study where rifaximin was used to treat inflammatory bowel disease in children 2.
Clinical Considerations
- It's essential to note that rifaximin is not FDA-approved for all these indications in pediatric populations, and treatment should be supervised by a pediatric specialist who can adjust dosing based on the specific clinical situation and the child's response to therapy.
- The choice of rifaximin dosage should prioritize the child's weight and the specific indication being treated, with careful monitoring for efficacy and potential side effects, as suggested by a study on the use of rifaximin in children with IBD 2.