Presenter: Carmelo Scarpignato, MD, DSc, PharmD, MPH

Original Date: June 5, 2016

Over the past decades, the poorly absorbed antibiotic rifaximin has gained popularity for SIBO eradication, despite that its use is not evidence based. To bridge this gap, a systematic review and meta-analysis of randomized and non-randomized studies was performed to evaluate the clinical efficacy and safety of rifaximin to eradicate SIBO in adult patients. 32 studies involving 1321 patients were included. The overall eradication rate according to intention to treat analysis was 67.8% (95% CI: 59.2 to 75.7). Meta-regression identified three covariates (namely the drug dose, the study design and co-therapy) independently associated with an increased eradication rate. The overall rate of adverse events was low (i.e. 5.6%). These data show that rifaximin therapy is effective and safe for the treatment of SIBO. However, since the quality of the available studies is generally poor, well-designed RCTs are needed to substantiate these findings and to establish the optimal regimen (i.e. daily dose and duration of rifaximin) for the treatment of this increasingly common condition.

Includes case presentation by Megan Taylor, ND and Allison Siebecker, ND, MSOM, LAc.

0.5 Pharmacology and 0.5 General (Total 1.0 CEUs) approved by OBNM