The effectiveness of rotating versus single course antibiotics for small intestinal bacterial overgrowth.
(2021) United European Gastroenterology Journal — Vol. 9, n° 6, p. 645-654 (2021)
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- Authors
Richard, Nicolas 
Melchior, Chloé
- Abstract
- (en) BACKGROUND: Small intestinal bacterial overgrowth treatment is usually based on antibiotics with no guidelines available. OBJECTIVE: This study aimed to investigate the efficacy of different antibiotics to treat small intestinal bacterial overgrowth. METHODS: Consecutive patients referred to our tertiary center and diagnosed with intestinal bacterial overgrowth were retrospectively included. Patients were diagnosed using a 75 g glucose breath test. Patients were treated either with a single antibiotic (quinolone or azole) or rotating antibiotics (quinolone and azole, one after the other) for 10 consecutive days per month for 3 months. A negative glucose breath test after antibiotic treatment was considered as remission. Quality of life (GIQLI) and gastrointestinal severity (IBS-SSS) were assessed before and after antibiotic treatment. Symptomatic evaluation was realized in simple blind of glucose breath test result: patients were unaware of their results. RESULTS: Between August 2005 and February 2020, 223 patients were included in the analysis (female 79.8%, mean age 50.2 ± 15.7 years). Remission was observed in 119 patients (53.4%) after one course of antibiotics and was more frequent in patients receiving rotating antibiotics than in patients receiving a single antibiotic (70.0% vs. 50.8%, p = 0.050). Remission was associated with a significant improvement in quality of life (p = 0.035) and in bloating (p = 0.004). CONCLUSION: In this study, the treatment of small intestinal bacterial overgrowth using rotating antibiotics was more effective than treatment using a single course of antibiotic. Remission was associated with improvement in both quality of life and bloating.
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Citations
Richard, N., Desprez, C., Wuestenberghs, F., Leroi, A.-M., Gourcerol, G., & Melchior, C. (2021). The effectiveness of rotating versus single course antibiotics for small intestinal bacterial overgrowth. United European Gastroenterology Journal, 9(6), 645-654. https://doi.org/10.1002/ueg2.12116 (Original work published 2021)