Clinical Trial: The Association Between Rifaximin And Partially Hydrolyzed Guar Gum Is More Effective Than Rifaximin Alone In Eradicating SIBO

Manuele Furnari (1) , Andrea Parodi (2) , Lorenzo Gemignani (1) , Edoardo G Giannini (1) , Simona Marenco (1) , Edoardo Savarino (1) , Lorenzo Assandri (1) , Valentina Fazio (1) , Daria Bonfanti (1) , Simona Inferrera (1) , Vincenzo Savarino (1)

1 Gastroenterology Unit
2 Gastroenterology

Background: Abnormal intestinal clearance is involved in the pathogenesis of small intestinal bacterial overgrowth (SIBO). It is known that partially hydrolyzed Guar gum (PHGG) affects intestinal motility. Eradication therapy of SIBO is based on antibiotic treatment: no data are available about the role of fibers supplementation in eradicating SIBO. Aims: To assess whether the association between PHGG plus rifaximin is more effective than rifaximin alone in the treatment of SIBO. Methods: 50g-glucose breath test (GBT) was given to 500 consecutive patients. Patients with positive GBT and predisposing conditions to SIBO entered into the study, and were randomized to receive rifaximin 1200mg/die or rifaximin 1200mg/die plus PHGG 5g/die for 10 days. Patients completed a symptom questionnaire and GBT both in basal condition and 1 month after withdrawal of therapy. Results: Seventy-seven patients had SIBO. SIBO eradication rate was 62.1% in the rifaximin group (both on per-protocol and intention-to-treat analyses), and 87.1% (per-protocol, p=0.017) and 85.0% (intention-to-treat, p=0.036) in the rifaximin-plus-PHGG group. Clinical improvement was observed in 86.9% and 91.1% of eradicated cases in rifaximin and rifaximin-plus-PHGG groups, respectively (p=0.677). Conclusion: The association between rifaximin and PHGG seems to be more useful in eradicating SIBO compared to rifaximin alone.

Mots clés: Medicine

Manuele Furnari, Andrea Parodi, Lorenzo Gemignani, Edoardo G Giannini, Simona Marenco, et al.. Clinical Trial: The Association Between Rifaximin And Partially Hydrolyzed Guar Gum Is More Effective Than Rifaximin Alone In Eradicating SIBO. Alimentary Pharmacology and Therapeutics, 2010, 32 (8), pp.1000. ⟨10.1111/j.1365-2036.2010.04436.x⟩. ⟨hal-00567044⟩