NATIONAL HARBOR, MD. – Treating patients with both rosacea and small intestinal bacterial overgrowth with the drug rifaximin was associated with improved rosacea symptoms in some patients, in a small, preliminary study. The findings were presented at the annual meeting of the American College of Gastroenterology.
Previous studies have shown a relationship between gastrointestinal bacteria and various skin disorders such as scleroderma, and a small case series showed that rosacea improved when patients with small intestinal bacterial overgrowth (SIBO) were treated with rifaximin, said Dr. Leonard B. Weinstock of Specialists in Gastroenterology in St. Louis.
Dr. Weinstock identified 63 patients with rosacea; the average age of the patients was 56 years. Most of them, 57 patients, had been diagnosed with facial rosacea by a dermatologist, and 4 had been diagnosed with ocular rosacea by an ophthalmologist. The rosacea patients were compared to 30 healthy controls and 30 general population controls. All study participants underwent lactulose breath testing to determine whether they had SIBO.
Overall, SIBO was significantly more common in the rosacea patients (50%) than in the general population controls (23%) or the healthy controls (10%). All four patients with ocular rosacea had SIBO.
A total of 32 rosacea patients were positive for SIBO, and 28 of these (including all ocular rosacea patients) received 1200 mg/day of rifaximin (two 200-mg tablets 3 times daily) for 10 days. Of the treated patients, 46% showed clearance of, or marked improvement in, rosacea symptoms, while another 25% showed moderate improvement.
"All four patients with ocular rosacea and SIBO reported marked improvement in conjunctivitis, sclera erythema, and dry eyes following treatment with rifaximin," Dr. Weinstock noted.
A large, randomized clinical trial is underway to further explore the possible benefits of rifaximin in patients with rosacea and SIBO, Dr. Weinstock added.
The study was supported by a grant from Salix Pharmaceuticals, maker of rifaximin.