{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:42:54Z","timestamp":1790649774369,"version":"4.1.0"},"reference-count":26,"publisher":"Consilium Medicum","issue":"8","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Terapevticheskii arkhiv"],"abstract":"<jats:p>Aim. To evaluate the efficacy of combination therapy with rifaximin and Saccharomyces boulardii CNCM I-745 versus rifaximin monotherapy in patients with small intestinal bacterial overgrowth (SIBO) associated with long-term proton pump inhibitor (PPI) use.\r\nMaterials and methods. A prospective comparative study with two parallel groups was conducted. Eligible patients were those on continuous long-term PPI therapy ( 3 months) with confirmed SIBO. SIBO was diagnosed in all patients using a lactulose Hydrogen\/Methane Breath Test (HMBT). Symptom severity was assessed using the validated \"7 \u00d7 7\" Questionnaire, and Quality of Life (QoL) was evaluated using the SF-36 Health Status Survey. Enrolled patients were randomized into two groups based on a 7-day treatment regimen: Group 1 received rifaximin (400 mg twice daily); Group 2 received rifaximin (400 mg twice daily) plus the probiotic Saccharomyces boulardii CNCM I-745 (Enterol\u00ae drug product, Biocodex, France; 500 mg twice daily). SIBO eradication was confirmed via repeat lactulose HMBT, and symptom severity\/QoL were reassessed 4 weeks after treatment completion.\r\nResults. 108 patients were enrolled (mean age 38.7 \u00b1 8.9 years; 65.7% female). Mean PPI treatment duration at enrollment was 4.81 months (95% confidence interval 4.15\u20135.46). At 4-week follow-up, repeat lactulose HMBT showed SIBO persistence in 41.5% of Group 1 (n = 22\/53) versus 21.8% in Group 2 (n = 12\/55; p = 0.038). Statistically significant resolution of diarrhea was observed only in Group 2 (p = 0.033). The final median \"7 \u00d7 7\" Questionnaire score was significantly lower in Group 2 (p = 0.0010). Both groups showed significant trends toward QoL improvement on the SF-36 survey.\r\nConclusion. This prospective comparative study demonstrates that combination therapy with rifaximin and Saccharomyces boulardii CNCM I-745 appears more effective than rifaximin monotherapy for SIBO eradication, symptom regression, and QoL improvement in patients with PPI-associated SIBO.<\/jats:p>","DOI":"10.26442\/00403660.2025.08.203301","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:28:44Z","timestamp":1756380524000},"page":"660-667","source":"Crossref","is-referenced-by-count":3,"title":["Study on the efficacy of combination therapy with rifaximin and &lt;i&gt;Saccharomyces boulardii&lt;\/i&gt; CNCM I-745 in patients with small intestinal bacterial overgrowth associated with long-term use of proton pump inhibitors"],"prefix":"10.26442","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6114-564X","authenticated-orcid":false,"given":"Igor V.","family":"Maev","sequence":"additional","affiliation":[{"name":"Russian University of 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Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9224-7382","authenticated-orcid":false,"given":"Diana T.","family":"Dicheva","sequence":"additional","affiliation":[{"name":"Russian University of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0982-2006","authenticated-orcid":false,"given":"Sergey V.","family":"Cheremushkin","sequence":"additional","affiliation":[{"name":"Russian University of Medicine"},{"name":"Semashko RZD-Medicine Clinical Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6387-1001","authenticated-orcid":false,"given":"Natalya V.","family":"Cheremushkin\u0430","sequence":"additional","affiliation":[{"name":"Russian University of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1511-6377","authenticated-orcid":false,"given":"Artem V.","family":"Vychkin","sequence":"additional","affiliation":[{"name":"Russian University of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"18344","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000501"},{"key":"ref2","unstructured":"\u041c\u0430\u0435\u0432 \u0418.\u0412., \u041a\u0443\u0447\u0435\u0440\u044f\u0432\u044b\u0439 \u042e.\u0410., \u0410\u043d\u0434\u0440\u0435\u0435\u0432 \u0414.\u041d., \u0418\u0432\u0430\u0448\u043a\u0438\u043d\u0430 \u041d.\u042e. \u0421\u0438\u043d\u0434\u0440\u043e\u043c \u0438\u0437\u0431\u044b\u0442\u043e\u0447\u043d\u043e\u0433\u043e \u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0440\u043e\u0441\u0442\u0430 \u0432 \u0442\u043e\u043d\u043a\u043e\u0439 \u043a\u0438\u0448\u043a\u0435: \u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0435 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