Study Characteristics of Studies Evaluating Symptomatic Response for Antibiotics in Patients With Small Intestinal Bacterial Overgrowth
| Study | Study type | Country | Sample size (% female) | Disease | Method to diagnose SIBO | Criteria for symptomatic improvement | Antibiotic used | Duration of therapy (day) | Duration of follow-up | Rate of improvement on antibiotics | Rate of improvement on placebo |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Biancone et al,16 2000 | Non-randomized | Italy | 14 (50%) | Crohn’s disease | Glucose breath test | Change in CDAI | Rifaximin 400 mg BID | 7 | 7 | 1/7 (0.0%) | 1/7 (0.0%) |
| Pimentel et al,22 2003 | RCT | US | 93 (62%) | IBS (Rome I) | Lactulose breath test | ≥ 50% reduction in composite score of abdominal pain, diarrhea, and constipation | Neomycin 500 mg BID | 10 | 7 | 21/46 (45.7%) | 7/47 (14.9%) |
| D’Incà et al,18 2007 | RCT | Italy | 22 | Diverticular disease | Lactulose breath test | Global symptomatic improvement | Rifaximin 600 mg BID | 14 | End of treatment | 8/12 (66.7%) | 0/10 (0.0%) |
| Ghoshal et al,23 2016 | RCT | India | 34 (19%) | IBS (Rome III) | Duodenal aspirate 103 CFU | No longer meeting Rome III criteria for IBS | Norfloxacin 400 mg BID | 10 | 30 | 12/19 (63.2%) | 0/15 (0.0%) |
| Ghoshal et al,19 2018 | RCT | India | 13 (54%) | Rome III IBS-C or FC | Lactulose breath test (methane) | BSS ≥ 3 | Rifaximin 400 mg BID | 14 | 7 | 5/6 (83.3%) | 4/7 (57.1%) |
| Furnari et al,17 2019 | RCT | Italy | 23 (48%) | Cystic fibrosis | Glucose breath test | ≥ 50% reduction in composite GI score | Rifaximin 10 mg/kg TID (up to 400 mg TID) | 14 | 21 | 4/11 (36.4%) | 2/9 (22.2%) |
SIBO, small intestinal bacterial overgrowth; CDAI, Crohn’s Disease Activity Index; BID, twice a day; RCT, randomized controlled trial; US, United States; IBS, irritable bowel syndrome; CFU, colony forming unit; IBS-C, constipation predominant IBS; FC, functional constipation; BSS, Bristol stool scale; GI, gastrointestinal; TID, three times a day.