Boltin Doron, Perets Tsachi Tsadok, Shporn Einav, Aizic Shoshana, Levy Sigal, Niv Yaron, Dickman Ram
The Neurogastroenterology Service, Department of Gastroenterology, Rabin Medical Center, Beilinson Campus and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinski Street, Petah Tikva 49100, Israel.
Ann Clin Microbiol Antimicrob. 2014 Oct 17;13:49. doi: 10.1186/s12941-014-0049-x.
Rifaximin is a minimally absorbed antibiotic with high luminal activity, used to treat various gastrointestinal diseases. Although rifaximin has been proposed as first line treatment for small intestinal bacterial overgrowth (SIBO), few data are available regarding its efficacy in non-IBS subjects. We aimed to assess the ability of rifaximin to normalize lactulose-H2 breath tests in non-IBS subjects with symptoms suggestive of SIBO.
Consecutive non-IBS patients presenting with bloating and flatulence were prospectively recruited and submitted to lactulose-H2 breath testing (LBT). Patients who had a positive result were offered rifaximin 1200 mg daily for 10 days. Breath testing was repeated two weeks after treatment completion in all patients in order to assess for response.
A total of 19 patients with a positive result received rifaximin and repeated the breath test (7 (36.8%) males, age 56.5 ± 17.6 years). The mean peak hydrogen excretion was 13.7 ± 2.8 and 10.3 ± 7.3 ppm at baseline and following rifaximin treatment, respectively (t = 1.98, p = 0.06). LBT normalized in 8/19 (42.1%) subjects. No patients reported symptom resolution. No adverse events were reported.
Strengths include the study's prospective design. Limitations include the small sample size and open label design.
Rifaximin was not effective in normalizing LBT in our cohort of non-IBS subjects with symptoms suggestive of SIBO.
利福昔明是一种吸收极少但具有高肠腔活性的抗生素，用于治疗各种胃肠道疾病。尽管利福昔明已被提议作为小肠细菌过度生长（SIBO）的一线治疗药物，但关于其在非肠易激综合征（IBS）患者中的疗效数据很少。我们旨在评估利福昔明使有SIBO症状的非IBS患者的乳果糖 - H2呼气试验正常化的能力。
前瞻性招募连续出现腹胀和肠胃胀气的非IBS患者，并进行乳果糖 - H2呼气试验（LBT）。对结果呈阳性的患者给予每日1200毫克利福昔明，持续10天。所有患者在治疗完成两周后重复呼气试验以评估反应。
共有19名结果呈阳性的患者接受了利福昔明治疗并重复了呼气试验（7名（占36.8%）男性，年龄56.5±17.6岁）。基线时和利福昔明治疗后的平均氢气排泄峰值分别为13.7±2.8和10.3±7.3 ppm（t = 1.98，p = 0.06）。19名受试者中有8名（42.1%）LBT恢复正常。没有患者报告症状缓解。未报告不良事件。
优点包括该研究的前瞻性设计。局限性包括样本量小和开放标签设计。
在我们有SIBO症状的非IBS受试者队列中，利福昔明未能有效使LBT正常化。
