rifaximin + neomycin

Rifaximin + neomycin is an investigational antibiotic combination therapy being evaluated by Cedars-Sinai Medical Center for the treatment of obesity and pre-diabetes in patients who test positive for methane-producing gut bacteria. The therapeutic rationale is based on the hypothesis that methanogens, particularly *Methanobrevibacter smithii*, produce methane gas that slows intestinal transit time, thereby increasing nutrient and calorie absorption and contributing to weight gain and impaired glucose tolerance. Rifaximin is a non-absorbable rifamycin derivative that inhibits bacterial RNA synthesis by binding to the beta-subunit of DNA-directed RNA polymerase. Neomycin is an aminoglycoside antibiotic that inhibits protein synthesis by binding to the 30S ribosomal subunit. The combination is typically administered orally (rifaximin 550 mg three times daily and neomycin 500 mg twice daily) for a 10-day course to eradicate these archaea and improve metabolic outcomes.

Brand names

Xifaxan

Other names

Antibiotic Treatment for Methane-Positive Pre-diabetics