The place of antibiotics in management of irritable bowel syndrome: a systematic review and meta-analysis
Open accessAbstract
INTRODUCTION: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease with an obscure pathophysiology. Current treatments for IBS have modest efficacy at best and the need for a robust therapy for IBS remains unmet. As small intestinal bacterial overgrowth has been proposed to be involved in pathogenesis of IBS, antibacterial agents might be efficacious in treatment of this condition. MATERIAL AND METHODS: PubMed, Embase, Scopus, Google Scholar, Web of Science, and Cochrane Central Register of Controlled Trials were searched for studies comparing the efficacy of antibiotics in the management of IBS and/or IBS type symptoms. Data were collected from 1966 to April 2009. Clinical response was considered as our key outcome of interest. RESULTS: Of five trials that evaluated the effect of antibiotics in IBS, two randomized placebo-controlled trials met the inclusion criteria for the meta-analysis. This meta-analysis included 234 patients with IBS-type symptoms of whom 181 met the Rome criteria for IBS. The pooled relative risk (RR) for "clinical response in IBS" was 2.04 (95% confidence interval [CI] of 1.23-3.40, p = 0.0061). The pooled RR for "clinical response in IBS-type symptoms" was 2.06 (95% CI of 1.3-3.27, p = 0.002). CONCLUSIONS: Although antibiotics have a statistically significant effect on IBS and bloating, given the evidence for the presence of publication bias, methodological variability of the trials and lack of a precise scientific explanation for the role of bacterial overgrowth in the pathophysiology of IBS, use of antibiotics on a regular basis in IBS patients is not recommended.
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These broad-spectrum antibiotics are absorbable, causing local and systemic side effects.
“however, these drugs are absorbable causing local and systemic side effects”
From Gut microbiota role in irritable bowel syndrome: New therapeutic strategies (2016) · cites this paper as [288]
Other broad-spectrum antibiotics reducing bacterial overgrowth have been challenged in the treatment of IBS, including tetracycline, amoxicillin clavulanate, metronidazole and fluoroquinolones such as norfloxacin.
“Other broad-spectrum antibiotics reducing bacterial overgrowth have been challenged in the treatment of IBS, including tetracycline, amoxicillin clavulanate, metronidazole and fluoroquinolones such as norfloxacin [287,288]”
From Gut microbiota role in irritable bowel syndrome: New therapeutic strategies (2016) · cites this paper as [288]
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- Authors
- Rezaie, A., Nikfar, S., & Abdollahi, M.
- Affiliations
- University of Alberta (CA)
- Ministry of Health and Medical Education (IR)
- Pharmaceutical Sciences Research Center (IR)
- Corresponding author
- Abdollahi, Mohammad
- Venue
- Archives of Medical Science
- Publisher
- Termedia Sp. z.o.o.
- Published
- 2010
- Volume
- 1
- Issue
- 1
- Pages
- 49-55
- ISSN
- 1734-1922 (ISSN-L)
- PMC
- PMC3278943
- OpenAlex
- W1981350408
- Cited by
- 40
- References
- 31
- Citations by year
- 2025: 3 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 4 · 2018: 1 · 2016: 6 · 2015: 4 · 2014: 7 · 2013: 1 · 2012: 4
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Archives of Medical Science (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- irritable bowel syndrome, antibiotics, small intestinal bacterial overgrowth, bloating, clinical response, Rome criteria, IBS pathophysiology, publication bias
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