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Rifaximin Alleviates Symptoms Due to Small Intestine Bacterial Overgrowth: Presented at ACG

By Bruce Sylvester

SAN DIEGO -- October 27, 2009 -- The majority of patients suffering from abdominal discomfort due to small intestine bacterial overgrowth can effectively combat their symptoms with the antibiotic rifaximin.

The treatment not only resolved symptoms in nearly 80% of patients, the treated individuals also said their quality of life had improved, said Charles W. Randall, MD, Gastroenterology Clinic of San Antonio, San Antonio, Texas.

"Given the high efficacy and excellent tolerability, rifaximin should be considered for first-line therapy for small intestine bacterial overgrowth," he said during his October 26 poster presentation at the American College of Gastroenterology (ACG) 74th Annual Scientific Meeting.

"Small intestine bacterial overgrowth is a common problem, producing symptoms such as increased intestinal gas, bloating, abdominal discomfort, and diarrhoea," Dr. Randall said. "Several treatments options are available that differ in regard to efficacy and adverse events."

Noting that rifaximin has been used off-label as a treatment option for the condition, Dr. Randall and colleagues enrolled 251 patients into an open-label study of the effectiveness of rifaximin. Nine patients were lost to follow-up, leaving 174 women and 68 men for his analysis.

The patients, all of whom were diagnosed through standard breath testing with small intestine bacterial overgrowth, received 400 mg rifaximin 3 times a day for 10 days.

Dr. Randall said 66.5% of the patients rated the treatment as excellent, in other words, their symptoms completely resolved. Another 12.4% of patients rated the treatment as satisfactory because their symptoms had alleviated to the point that no further medical treatment was required. Another 21% of patients considered the treatment unsatisfactory because symptoms persisted without any improvement in their quality of life.

"We found that treatment with rifaximin is successful in reducing the symptoms of small intestine bacterial overgrowth and improving quality of life in 78.9% of patients," Dr. Randall said. "No side effects were reported and treatment was efficacious in all ages and in both men and women."

The mean age of the patients was 56.3 years, but the ages ranged from 18 to 92 years. The mean follow-up was 7.7 months, and ranged from 1 to 30 months, he said.

Dr. Randall is a consultant for Salix Pharmaceuticals, Montville, North Carolina; this study did not receive direct funding from Salix Pharmaceuticals.

[Presentation title: Rifaximin Is Efficacious in the Treatment of Small Intestine Bacterial Overgrowth. Abstract 534]

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