Rifaximin dose-finding study for the treatment of small intestinal bacterial overgrowth

Aliment Pharmacol Ther. 2005 Jul 1;22(1):31-5. doi: 10.1111/j.1365-2036.2005.02516.x.


Background: Few controlled studies assessing choice and duration of antibiotic therapy for small intestinal bacterial overgrowth are available.

Aim: To assess efficacy, safety and tolerability of different doses of rifaximin, a broad spectrum non-absorbable antibiotic, for intestinal bacterial overgrowth eradication.

Methods: We enrolled 90 consecutive patients affected by small intestinal bacterial overgrowth. The presence of small intestinal bacterial overgrowth was based on the occurrence of a rise of H2 values >12 p.p.m. above the basal value after 50 g glucose ingestion. Patients were randomized in three 7-day treatment groups: rifaximin 600 mg/day (group 1); rifaximin 800 mg/day (group 2) and rifaximin 1200 mg/day (group 3). Glucose breath test was reassessed 1 month after the end of therapy. Compliance to the treatment and incidence of side-effects were also evaluated.

Results: No drop-outs were observed in the three groups. Glucose breath test normalization rate was significantly higher in group 3 (60%) with respect to group 1 (17%; P < 0.001) and group 2 (27%, P < 0.01). No significant differences in patient compliance and incidence of side-effects were found among groups.

Conclusions: Higher doses of rifaximin lead to a significant gain in terms of therapeutic efficacy in small intestinal bacterial overgrowth eradication without increasing the incidence of side-effects.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Bacterial Infections / drug therapy*
  • Breath Tests
  • Dose-Response Relationship, Drug
  • Female
  • Gastrointestinal Agents / administration & dosage*
  • Gastrointestinal Diseases / drug therapy*
  • Humans
  • Intestine, Small*
  • Male
  • Rifamycins / administration & dosage*
  • Rifamycins / adverse effects
  • Rifaximin


  • Anti-Bacterial Agents
  • Gastrointestinal Agents
  • Rifamycins
  • Rifaximin