High dosage rifaximin for the treatment of small intestinal bacterial overgrowth.
BACKGROUND
Rifaximin is a broad spectrum non-absorbable antibiotic used for treatment of small intestinal bacterial overgrowth. Doses of 1200 mg/day showed a decontamination rate of 60% with low side-effects incidence.


OBJECTIVE
To assess efficacy, safety and tolerability of rifaximin 1600 mg with respect to 1200 mg/day for small intestinal bacterial overgrowth treatment.


METHODS
Eighty consecutive small intestinal bacterial overgrowth patients were enrolled. Diagnosis of small intestinal bacterial overgrowth based the clinical history and positivity to H(2)/CH(4) glucose breath test. Patients were randomized in two 7-day treatment groups: rifaximin 1600 mg (group 1); rifaximin 1200 mg (group 2). Glucose breath test was reassessed 1 month after. Compliance and side-effect incidence were also evaluated.


RESULTS
One drop-out was observed in group 1 and two in group 2. Glucose breath test normalization rate was significantly higher in group 1 with respect to group 2 both in intention-to-treat (80% vs. 58%; P < 0.05) and per protocol analysis (82% vs. 61%; P < 0.05). No significant differences in patient compliance and incidence of side effects were found between groups.


CONCLUSIONS
Rifaximin 1600 mg/day showed a significantly higher efficacy for small intestinal bacterial overgrowth treatment with respect to 1200 mg with similar compliance and side-effect profile.
Scarpellini
E
E
Internal Medicine Department, Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy.
Gabrielli
M
M
Lauritano
C E
CE
Lupascu
A
A
Merra
G
G
Cammarota
G
G
Cazzato
I A
IA
Gasbarrini
G
G
Gasbarrini
A
A
D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001944:Breath Tests / Q000379:methods; D004305:Dose-Response Relationship, Drug; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology*; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012294:Rifamycins / Q000008:administration & dosage*; D000078262:Rifaximin; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D005765:Gastrointestinal Agents; D012294:Rifamycins; D000078262:Rifaximin