What Are Some Less Expensive Options For Xifaxan To Treat SIBO?

Quick Answer

If the cost of rifaximin is too high for you, there are more affordable options available, such as trimethoprim-sulfamethoxazole, norfloxacin, ciprofloxacin, metronidazole, tetracycline, or amoxicillin-clavulanic acid.

Detailed Answer

It's not entirely clear in your question, but it seems that your doctor diagnosed you with SIBO (small intestinal bacterial overgrowth) based on your mention of an abnormal amount of methane gas in a lab test.

What Is SIBO & How Is It Diagnosed?

Small intestinal bacterial overgrowth (SIBO) is a condition where there are an excessive number of bacteria in your small bowel. People with SIBO typically experience symptoms such as bloating, gas, belly pain, or diarrhea.

In some cases of SIBO, an excess of methane gas is produced, which is referred to as intestinal methanogen overgrowth (IMO).

The diagnosis of SIBO is confirmed through a carbohydrate breath test or a test to find a high bacterial concentration in a jejunal aspirate culture. The carbohydrate breath test is usually the initial step due to its simplicity and non-invasive nature.

Antibiotic Choices

The primary treatment for SIBO involves antibiotics that reduce, but not necessarily eliminate, the population of small intestinal bacteria.

Antibiotic therapy typically commences after a positive breath test. This process takes into account various factors such as the pattern and extent of bacterial overgrowth, risks of antibiotic resistance, potential allergic reactions, and cost-effectiveness.

The therapy usually involves Xifaxan (rifaximin), the drug you mentioned in your question, which is a non-absorptive rifamycin derivative that is well-tolerated and effective in managing SIBO. However, due to its high cost, alternatives are often considered. This is the situation you described.

Before moving forward, I want to mention that for patients specifically diagnosed with Intestinal Methanogen Overgrowth, a combination therapy of neomycin and rifaximin is often utilized and has the strongest evidence of benefit.

Nevertheless, even though rifaximin has demonstrated superior effectiveness against SIBO compared to its alternatives, its high-cost drives individuals to consider more affordable options, such as:

• Trimethoprim-sulfamethoxazole
• Norfloxacin
• Ciprofloxacin
• Metronidazole
• Tetracycline
• Amoxicillin-clavulanic acid

As mentioned, these antibiotics do not have the same level of evidence for benefit as rifaximin does, but they can still be effective. All of these antibiotics are significantly less expensive than rifaximin.

Below is a chart that lists antibiotics used for treating SIBO.

Final Words

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