Therapeutic efficacy of amoxicillin and rifaximin in patients with small intestinal bacterial overgrowth and Helicobacter pylori infection

Abstract

IntroductionSmall intestinal bacterial overgrowth (SIBO) may coexist with Helicobacter pylori infection, which can be the cause of chronic gastrointestinal complaints.AimEvaluation of the therapeutic efficacy of amoxicillin and rifaximin in the treatment of these diseases.Material and methodsThe lactulose hydrogen breath test (LHBT) and the urea breath test (13C-UBT) were performed in 116 patients. In 62 patients the coexistence of small intestinal bacterial overgrowth and H. pylori infection was observed. Then, in group I (n = 30) pantoprazole (2 × 40 mg), amoxicillin (2 × 1000 mg) and metronidazole (2 × 500 mg) and in group II (n = 32) pantoprazole and amoxicillin at the above doses and rifaximin (3 × 400 mg) were administered for 10 days. After 6 weeks, both breath tests were repeated and the degree of remission of symptoms was measured using a 10-point visual analog scale (VAS).ResultsAfter the treatment the LHBT index decreased in group I from 61.2 ±19.4 ppm to 22.0 ±8.2 ppm (p < 0.001) and in group II from 59.6 ±15.5 ppm to 15.2 ±8.6 ppm (p < 0.001). Eradication of H. pylori (13C-UBT below 4.0‰) was achieved in 63.3% of patients in group I and 59.4% in group II (p > 0.05). The decrease of pain below 3.0 points in the VAS was obtained in 64.8% of patients in group I and in 56.2% in group II.ConclusionsCombination of amoxicillin and rifaximin may be effective in the treatment of patients with small intestinal bacterial overgrowth syndrome and concomitant H. pylori infection.

Anti-Helicobacter pylori treatment can effectively improve the clinical remission rates of irritable bowel syndrome: a controlled clinical trial meta-analysis

“…Patients with H. pylori are more likely to test positive for SIBO ( 32 ). Further, H. pylori eradication therapy can effectively relieve the clinical symptoms of patients with SIBO ( 33 ), which also suggests there is some correlation between H. pylori infection, and SIBO and IBS. Anti- H. pylori treatment may relieve the clinical symptoms of IBS by ameliorating SIBO.…”

Health Benefits of Heat-Killed (Tyndallized) Probiotics: An Overview

“…SIBO is a common gastrointestinal dysbiosis that can be caused by the overuse of certain drugs such as proton pump inhibitors. The long-term reduction of gastric secretion creates favorable conditions for the colonization of various bacterial species in the upper gastrointestinal tract [146]. Moreover, it is also known that H. pylori infection can also alter the microbiota of the upper gastrointestinal tract, and active H. pylori infection has been found to be significantly associated with the presence of SIBO [146,147].…”

Selenium in Human Health and Gut Microflora: Bioavailability of Selenocompounds and Relationship With Diseases

“…Some studies have corroborated that thyroid disorders are the causal factor in the relationship with gut microbes. Other studies have demonstrated that bacteria might act as the motivating factor, as thyroid function may be impaired in patients with small intestinal bacterial overgrowth (140,141). However, the causative role of Se deficiency, thyroid and gut microbiota has not been thoroughly ascertained yet and further clinical studies are highly recommended.…”