Study Characteristics of Studies Evaluating Symptomatic Response for Antibiotics in Irritable Bowel Syndrome Patients With Small Intestinal Bacterial Overgrowth Compared to No Small Intestinal Bacterial Overgrowth
Study | Analyzed study type | Country | Sample size (% female) | IBS type | Method to diagnose SIBO | Criteria for symptomatic improvement | Antibiotic used | Duration of therapy (day) | Duration of follow-up (day) | Rate of improvement for patients with SIBO | Rate of improvement for patients without SIBO |
---|---|---|---|---|---|---|---|---|---|---|---|
Pimentel et al,22 2003 | Cohort | US | 55 (62%) |
Rome I IBS-D: 48% IBS-C: 35% Other: 13% |
Lactulose breath test | ≥ 50% reduction in composite score of abdominal pain, diarrhea, and constipation | Neomycin 500 mg BID | 10 | 7 | 21/46 (45.7%) | 3/9 (33.3%) |
Ghoshal et al,23 2016 | Cohort | India | 40 (19%) | Rome III IBS | Duodenal aspirate 103 CFU | No longer meeting Rome III criteria for IBS | Norfloxacin 400 mg BID | 10 | 30 | 12/19 (63.2%) | 3/21 (14.3%) |
Rezaie et al,21 2019 | Cohort | US | 93 (67%) | Rome III IBS-D | Lactulose breath test | ≥ 30% decrease weekly abdominal pain and ≥ 50% decrease in day/wk with BSS type 6 or 7 stool during ≥ 2 wk | Rifaximin 550 mg TID | 14 | 28 | 37/62 (59.6%) | 8/31 (43.9%) |
Zhuang et al,20 2020 | Cohort | China | 78 (33%) | Rome IV IBS-D | Lactulose breath test | 50% improvement in the global GI symptoms | Rifaximin 400 mg TID | 14 | 14 | 18/45 (40.0%) | 8/33 (24.2%) |
IBS, irritable bowel syndrome; SIBO, small intestinal bacterial overgrowth; US, United States; IBS-D, diarrhea predominant IBS; IBS-C, constipation predominant IBS; BID, twice a day; CFU, colony forming unit; BSS, Bristol stool scale; TID, three times a day; GI, gastrointestinal.