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Although some studies indicate that small intestinal bacterial overgrowth (SIBO) is prevalent in irritable bowel syndrome (IBS), it remains unclear whether SIBO causes IBS. The poorly absorbed, gut-specific antibiotic, rifaximin, may be well suited to treat SIBO in IBS.
The TARGET study combines data from a pair of large, well-designed, phase III registration trials in 1260 IBS patients with mild-to-moderate, non-constipating symptoms. Patients were randomised to receive either rifaximin, 550 mg three times daily for 2 weeks, or placebo. There was no effort to test for SIBO before treatment, which was initiated empirically. The main outcome measure was improvement in global IBS symptoms as determined using a binary assessment. Secondary outcomes included improvement in individual IBS symptoms, such as bloating, abdominal pain and stool consistency. Measurements of efficacy were made over a 4-week period following treatment.
Significantly, more patients in the rifaximin arms achieved adequate relief …
Competing interests BS has received grants from Takeda, Prometheus, Movetis. Advisor for Salix, Prometheus, Ironwood, Movetis, AstraZeneca.