# Which antibiotic to use for SIBO



## cynthia (May 9, 2006)

I've been following posts on this forum for a couple of months in an attempt to help my son who's suffering from SIBO. I wasn't able to get the Pimental book (already out of print when I looked in June) so I've been getting lots of information from everyone on this site.I have a question about which is the proper antibiotic to use. I know that Pimental says to use rifaximin for high hydrogen levels and neomycin for high methane levels. But it seems like that may not necessarily work - at least when I read posts here. So - is there anyway to determine which antibiotic (one of these or even another one) will be most effective on your particular bacteria? I know with other bacteria the doctor can culture it to determine what drug to go with. Is there anything like that for SIBO?Thanks,Cynthia


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## Kathleen M. (Nov 16, 1999)

They can diagnose SIBO by cultureing the bacteria iin the small intestine, but I'm unclear if they do a differential on that which would give you the best antibiotic. Some of the gut bacteria are rather difficult to grow in the lab so that complicates things.Most of the reports from clinics that do this is they try one then retest for the SIBO if symptoms don't go away then try another.I think most people who are trying antibiotics here were never tested for SIBO so it is hard to judge the results. They just tried the antibitoics in case, and many places don't have testing equipment and stuff so they opted for the just try it and hope version.K.


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## cynthia (May 9, 2006)

Hi Kathleen,When you say they culture the bacteria in the small intestine, does that mean they go down your throat with a tube? - It sounds like choosing an antibiotic for SIBO is sort of a hit or miss proposition!


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## Kathleen M. (Nov 16, 1999)

Yep, other than breath tests the way to diagnose SIBO is to snake a tube in there, I'm not sure how far they can sample. Most of the early breath test studies compared the results to going in with a tube.K.


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