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Three Ways to Eradicate SIBO Three main methods are used to eradicate SIBO: taking prescription antibiotics, natural antimicrobials, and the elemental diet. Let’s look at the pros and cons of each of these treatment methods. Eradication Option #1: Prescription antibiotics. Rifaximin is the antibiotic most commonly recommended for SIBO. Xifaxan is a brand name of Rifaximin that is commonly prescribed. While I’m not a big fan of antibiotics, Rifaximin is different than most other antibiotics. First, it is a nonabsorbable antibiotic whose activity is localized to the small intestine due to its minimal systemic absorption. Thus, unlike most other antibiotics, Rifaximin doesn’t go through the bloodstream, but only acts in the small intestine and won’t harm the bacteria of the large intestine. Evidence shows that Rifaximin might actually increase good bacteria (e.g., bifidobacteria) in the large intestine.[4] In addition, bacterial resistance isn’t too common when using Rifaximin. However, some people with SIBO will respond to Rifaximin, and they will need to consider either the elemental diet or herbal antimicrobials. Also, if someone has high methane levels, Rifaximin alone usually won’t successfully eradicate SIBO, which is why most medical doctors will recommend an additional antibiotic, such as metronidazole or neomycin.
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Eric Osansky (Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers)