Review of rifaximin as treatment for SIBO and IBS.

BACKGROUND: Rifaximin is a broad-range, gastrointestinal-specific antibiotic that demonstrates no clinically relevant bacterial resistance. Therefore, rifaximin may be useful in the treatment of gastrointestinal disorders associated with altered bacterial flora, including irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO).

OBJECTIVE: To review rifaximin for treatment of IBS and SIBO.

METHODS: Review of rifaximin clinical trials.

RESULTS/CONCLUSION: Rifaximin improved global symptoms in 33 - 92% of patients and eradicated SIBO in up to 84% of patients with IBS, with results sustained up to 10 weeks post-treatment. Rifaximin caused a lower number of adverse events compared with metronidazole or levofloxacin and may have a more favorable adverse event profile than systemic antibiotics, without clinically relevant antibiotic resistance.