In Vitro Preliminary Evaluation of a New Rifamycin In Situ Gelling Formulation for Pouchitis Treatment

Pouchitis is one of the most common long-term complications after ileal pouch-anal anastomosis (IPAA) surgery, with a reported incidence rate of up to 50%. Identifying specific bacteria involved in the pathogenesis has important implications for clinical management. Indeed, antibiotic therapy is a common treatment option, but antibiotic choice and treatment duration can vary depending on the severity of symptoms and the bacteria involved. Ansamycins are effective in the management of antibiotic-dependent pouchitis. Therefore, this study aimed to test the in vitro antibacterial activity of a novel rifamycin gel solution, specifically intended for treating infections associated with pouchitis, with the agar diffusion assay. Furthermore, the in vitro antibacterial activity of rifamycin sodium salt against several bacterial strains involved in pouchitis was compared with the gel formulation. Rifamycin's in vitro anti-microbial characteristics were not affected by the gel formulation. These results, although preliminary, support the potential of the Rifamycin Gel formulation as a valuable addition to the therapeutic armamentarium for this challenging condition.