Oral antibiotic therapy improves fat absorption in cystic fibrosis patients with small intestine bacterial overgrowth

Abstract

Background: The aim of the present study was to assess the influence of antibiotic therapy on fat assimilation in cystic fibrosis (CF) patients with small intestine bacterial overgrowth (SIBO).

Materials and methods: Twenty six pancreatic insufficient CF patients with bronchopulmonary exacerbation and diagnosed SIBO (positive hydrogen-methane breath test) entered the study. (13)C mixed triglyceride breath test was performed before and after antibiotic therapy. Sixteen subjects were treated intravenously (ceftazidime and amikacin), ten patients orally (ciprofloxacin).

Results: Cumulative percentage dose recovery changed significantly in the subgroup receiving antibiotics orally [median (mean±SEM): 3.6% (4.5±1.3%) vs. 7.2 (6.9±1.6%); p=0.019]. In the subgroup with intravenous drug administration, the tendency towards improvement was noted [2.7 (4.3±1.5%) vs. 5.2 (5.7±0.8%); p=0.109].

Conclusions: Antibiotic therapy applied in CF patients with SIBO in the course of pulmonary exacerbation results in a significant improvement of fat digestion and absorption.