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Rifaximin dose-finding study for the treatment of small intestinal bacterial overgrowth

E C Lauritano1, M Gabrielli, A Lupascu

  • 1Internal Medicine Department, Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy.

Alimentary Pharmacology & Therapeutics
|June 21, 2005
PubMed
Abstract

Insights

Higher doses of rifaximin significantly improve small intestinal bacterial overgrowth eradication. This study found increased efficacy with higher rifaximin dosages without additional side effects, offering a better treatment option.

Area of Science:

  • Gastroenterology
  • Microbiology
  • Pharmacology

Background:

  • Limited controlled studies exist on antibiotic therapy for small intestinal bacterial overgrowth (SIBO).
  • Investigating optimal antibiotic regimens for SIBO is crucial for effective patient management.

Purpose of the Study:

  • To evaluate the efficacy, safety, and tolerability of varying rifaximin doses for SIBO eradication.
  • Rifaximin, a non-absorbable antibiotic, was tested at different dosages.

Main Methods:

  • 90 patients with SIBO were randomized into three groups receiving 7-day rifaximin treatments: 600 mg/day, 800 mg/day, or 1200 mg/day.
  • SIBO diagnosis was confirmed via glucose breath test (H2 >12 p.p.m.).
  • Efficacy was reassessed one month post-treatment using the glucose breath test; compliance and side effects were monitored.

Main Results:

  • The highest rifaximin dose (1200 mg/day) showed a significantly higher SIBO eradication rate (60%) compared to lower doses (17% for 600 mg/day, 27% for 800 mg/day).
  • No significant differences in treatment compliance or incidence of side effects were observed across the different dosage groups.
  • All patients completed the study without drop-outs.

Conclusions:

  • Higher doses of rifaximin demonstrate superior therapeutic efficacy in eradicating SIBO.
  • Increasing rifaximin dosage for SIBO treatment enhances effectiveness without compromising safety or tolerability.

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