Absorbable vs. non-absorbable antibiotics in the treatment of small intestine bacterial overgrowth in patients with blind-loop syndrome

M. Di Stefano, E. Miceli, A. Missanelli, S. Mazzocchi, G. R. Corazza

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background: Small intestine bacterial overgrowth is associated with the presence of predisposing conditions, acting through different mechanisms. Therefore, the failure to define a standardized therapy may be due to a methodological bias: to treat a condition characterized by different pathophysiological mechanisms with the same pharmacological approach. Non-absorbable antibiotics could have a lower efficacy than absorbable drugs in patients with blind loops which exclude a portion of the intestine from the transit. Aim: To evaluate the efficacy of absorbable vs. non-absorbable antibiotics in this subgroup of patients. Methods: A group of small intestine bacterial overgrowth patients with total gastrectomy or gastrojejunostomy and blind loop underwent a therapeutic trial comparing rifaximin to metronidazole. Seven patients underwent a course of rifaximin followed by a course of metronidazole on recurrence of symptoms. To compare the effect of the drugs, another two groups of patients underwent two consecutive courses of rifaximin or metronidazole. Hydrogen breath test after glucose administration and symptom severity measurement were performed. Results: Both drugs reduced breath H 2 excretion but a much better improvement was achieved after metronidazole. Symptom improvement was higher after metronidazole. Conclusion: Metronidazole is more effective than rifaximin for the treatment of small intestine bacterial overgrowth associated with the presence of a blind loop.

Original languageEnglish
Pages (from-to)985-992
Number of pages8
JournalAlimentary Pharmacology and Therapeutics
Volume21
Issue number8
DOIs
Publication statusPublished - Apr 15 2005

Fingerprint

Blind Loop Syndrome
rifaximin
Metronidazole
Small Intestine
Anti-Bacterial Agents
Therapeutics
Pharmaceutical Preparations
Breath Tests
Gastric Bypass
Gastrectomy
Intestines
Hydrogen
Pharmacology
Glucose
Recurrence

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

@article{7aa9a5a44b3b450ea870e08e00ad6ea5,
title = "Absorbable vs. non-absorbable antibiotics in the treatment of small intestine bacterial overgrowth in patients with blind-loop syndrome",
abstract = "Background: Small intestine bacterial overgrowth is associated with the presence of predisposing conditions, acting through different mechanisms. Therefore, the failure to define a standardized therapy may be due to a methodological bias: to treat a condition characterized by different pathophysiological mechanisms with the same pharmacological approach. Non-absorbable antibiotics could have a lower efficacy than absorbable drugs in patients with blind loops which exclude a portion of the intestine from the transit. Aim: To evaluate the efficacy of absorbable vs. non-absorbable antibiotics in this subgroup of patients. Methods: A group of small intestine bacterial overgrowth patients with total gastrectomy or gastrojejunostomy and blind loop underwent a therapeutic trial comparing rifaximin to metronidazole. Seven patients underwent a course of rifaximin followed by a course of metronidazole on recurrence of symptoms. To compare the effect of the drugs, another two groups of patients underwent two consecutive courses of rifaximin or metronidazole. Hydrogen breath test after glucose administration and symptom severity measurement were performed. Results: Both drugs reduced breath H 2 excretion but a much better improvement was achieved after metronidazole. Symptom improvement was higher after metronidazole. Conclusion: Metronidazole is more effective than rifaximin for the treatment of small intestine bacterial overgrowth associated with the presence of a blind loop.",
author = "{Di Stefano}, M. and E. Miceli and A. Missanelli and S. Mazzocchi and Corazza, {G. R.}",
year = "2005",
month = "4",
day = "15",
doi = "10.1111/j.1365-2036.2005.02397.x",
language = "English",
volume = "21",
pages = "985--992",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "8",

}

TY - JOUR

T1 - Absorbable vs. non-absorbable antibiotics in the treatment of small intestine bacterial overgrowth in patients with blind-loop syndrome

AU - Di Stefano, M.

AU - Miceli, E.

AU - Missanelli, A.

AU - Mazzocchi, S.

AU - Corazza, G. R.

PY - 2005/4/15

Y1 - 2005/4/15

N2 - Background: Small intestine bacterial overgrowth is associated with the presence of predisposing conditions, acting through different mechanisms. Therefore, the failure to define a standardized therapy may be due to a methodological bias: to treat a condition characterized by different pathophysiological mechanisms with the same pharmacological approach. Non-absorbable antibiotics could have a lower efficacy than absorbable drugs in patients with blind loops which exclude a portion of the intestine from the transit. Aim: To evaluate the efficacy of absorbable vs. non-absorbable antibiotics in this subgroup of patients. Methods: A group of small intestine bacterial overgrowth patients with total gastrectomy or gastrojejunostomy and blind loop underwent a therapeutic trial comparing rifaximin to metronidazole. Seven patients underwent a course of rifaximin followed by a course of metronidazole on recurrence of symptoms. To compare the effect of the drugs, another two groups of patients underwent two consecutive courses of rifaximin or metronidazole. Hydrogen breath test after glucose administration and symptom severity measurement were performed. Results: Both drugs reduced breath H 2 excretion but a much better improvement was achieved after metronidazole. Symptom improvement was higher after metronidazole. Conclusion: Metronidazole is more effective than rifaximin for the treatment of small intestine bacterial overgrowth associated with the presence of a blind loop.

AB - Background: Small intestine bacterial overgrowth is associated with the presence of predisposing conditions, acting through different mechanisms. Therefore, the failure to define a standardized therapy may be due to a methodological bias: to treat a condition characterized by different pathophysiological mechanisms with the same pharmacological approach. Non-absorbable antibiotics could have a lower efficacy than absorbable drugs in patients with blind loops which exclude a portion of the intestine from the transit. Aim: To evaluate the efficacy of absorbable vs. non-absorbable antibiotics in this subgroup of patients. Methods: A group of small intestine bacterial overgrowth patients with total gastrectomy or gastrojejunostomy and blind loop underwent a therapeutic trial comparing rifaximin to metronidazole. Seven patients underwent a course of rifaximin followed by a course of metronidazole on recurrence of symptoms. To compare the effect of the drugs, another two groups of patients underwent two consecutive courses of rifaximin or metronidazole. Hydrogen breath test after glucose administration and symptom severity measurement were performed. Results: Both drugs reduced breath H 2 excretion but a much better improvement was achieved after metronidazole. Symptom improvement was higher after metronidazole. Conclusion: Metronidazole is more effective than rifaximin for the treatment of small intestine bacterial overgrowth associated with the presence of a blind loop.

UR - http://www.scopus.com/inward/record.url?scp=17244366179&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=17244366179&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2036.2005.02397.x

DO - 10.1111/j.1365-2036.2005.02397.x

M3 - Article

VL - 21

SP - 985

EP - 992

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 8

ER -