title: Small intestinal bacterial overgrowth recurrence after antibiotic therapy.
abstract: OBJECTIVE
  Current treatment for small intestinal bacterial overgrowth (SIBO) is based on courses of broad-spectrum antibiotics. No data concerning SIBO recurrence are available. The aims of the present study were to investigate SIBO recurrence as assessed by glucose breath test (GBT) after antibiotic treatment and conditions associated to SIBO recurrence.
  
  
  METHODS
  Eighty consecutive patients affected by SIBO and decontaminated by rifaximin (1,200 mg per day for 1 wk) were enrolled. Diagnosis of SIBO was based on GBT. GBT was reassessed at 3, 6, and 9 months after evidence of GBT normalization. GBT positivity recurrence, predisposing conditions, and gastrointestinal symptoms were evaluated.
  
  
  RESULTS
  Ten (10/80, 12.6%), 22 (22/80, 27.5%), and 35 (35/80, 43.7%) patients showed positivity to GBT at 3, 6, and 9 months after successful antibiotic treatment, respectively. At multivariate analysis, older age (OR 1.09, 95% CI 1.02-1.16), history of appendectomy (OR 5.9, 95% CI 1.45-24.19), and chronic use of proton pump inhibitors (PPIs) (OR 3.52, 95% CI 1.07-11.64) were significantly associated to GBT positivity recurrence. All gastrointestinal symptoms significantly increased at 3, 6, and 9 months in patients with evidence of GBT positivity recurrence.
  
  
  CONCLUSIONS
  GBT positivity recurrence rate was high after antibiotic treatment. Older age, history of appendectomy, and chronic use of PPIs were associated with GBT positivity recurrence. Patients with evidence of GBT positivity recurrence showed gastrointestinal symptoms relapse thus suggesting SIBO recurrence.
authors.affiliation: Internal Medicine Department, Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Ernesto C
authors.initials: EC
authors.lastname: Lauritano
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gabrielli
authors.forename: Emidio
authors.initials: E
authors.lastname: Scarpellini
authors.forename: Andrea
authors.initials: A
authors.lastname: Lupascu
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Novi
authors.forename: Sandra
authors.initials: S
authors.lastname: Sottili
authors.forename: Giovanna
authors.initials: G
authors.lastname: Vitale
authors.forename: Valentina
authors.initials: V
authors.lastname: Cesario
authors.forename: Michele
authors.initials: M
authors.lastname: Serricchio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cammarota
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gasbarrini
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001765:Blind Loop Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D001944:Breath Tests; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D012294:Rifamycins; D000078262:Rifaximin