Yang Janet, Lee Hyo-Rang, Low Kimberly, Chatterjee Soumya, Pimentel Mark
GI Motility Program, GI Motility Laboratory, Cedars-Sinai Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Dig Dis Sci. 2008 Jan;53(1):169-74. doi: 10.1007/s10620-007-9839-8. Epub 2007 May 23.
Previous studies demonstrate improvement in IBS after antibiotic therapy, with the greatest efficacy seen with the antibiotic, rifaximin. The purpose of this study was to compare the efficacy of rifaximin in both the treatment and retreatment of IBS.
A retrospective chart review was conducted on Rome I-positive IBS patients. Charts were reviewed to evaluate all antibiotic treatments (rifaximin, neomycin, doxycycline, amoxicillin/clavulanate, and ciprofloxacin), even those predating 1 July 2004. Data collection included symptoms, breath test results (pre- and post-treatment), antibiotics used, and clinical response to individual antibiotic treatments before and after rifaximin availability in the USA.
Out of 98 eligible charts, 84 patients received one course of rifaximin. Fifty of these (60%) had a follow-up breath test. Among these, 31 (62%) were clinical responders and 19 (38%) were nonresponders. Of 31 responders, 25 (81%) had a normal follow-up breath test compared with only 3 of the 19 nonresponders (16%) (P < 0.001). Of participants given rifaximin, 69% (58 out of 84) had a clinical response compared with only 38% (9 out of 24) with neomycin (P < 0.01) and 44% (27 out of 61) with all non-rifaximin antibiotics (P < 0.01). Rifaximin was used as retreatment on 16 occasions, and all patients improved.
Rifaximin is more effective than other antibiotics in the treatment and retreatment of IBS.
既往研究表明抗生素治疗后肠易激综合征（IBS）有所改善，其中抗生素利福昔明的疗效最为显著。本研究的目的是比较利福昔明在IBS治疗和再治疗中的疗效。
对符合罗马I标准的IBS患者进行回顾性病历审查。审查病历以评估所有抗生素治疗（利福昔明、新霉素、强力霉素、阿莫西林/克拉维酸和环丙沙星），甚至包括2004年7月1日前的治疗。数据收集包括症状、呼气试验结果（治疗前和治疗后）、使用的抗生素以及在美国有了利福昔明之后，个体抗生素治疗前后的临床反应。
在98份符合条件的病历中，84例患者接受了一个疗程的利福昔明治疗。其中50例（60%）进行了随访呼气试验。在这些患者中，31例（62%）为临床反应者，19例（38%）为无反应者。在31例反应者中，25例（81%）随访呼气试验结果正常，而19例无反应者中只有3例（16%）结果正常（P<0.001）。接受利福昔明治疗的参与者中，69%（84例中的58例）有临床反应，而新霉素治疗组只有38%（24例中的9例）有临床反应（P<0.01），所有非利福昔明抗生素治疗组为44%（61例中的27例）有临床反应（P<0.01）。利福昔明有16次被用作再治疗，所有患者均有改善。
在IBS的治疗和再治疗中，利福昔明比其他抗生素更有效。
