{ "schema_version": 1, "kind": "condition", "id": "small-intestinal-bacterial-overgrowth", "name": "Small Intestinal Bacterial Overgrowth (SIBO)", "category": "chronic", "sources": "ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth 2020 · Egyptian National Drug Formulary - Antimicrobial 2023 (metronidazole monograph) · Small Intestinal Bacterial Overgrowth - StatPearls - NCBI Bookshelf (NBK546634) - the article states the dose for this indication · Cyanocobalamin DailyMed label, SetID 41ac0dc1-0a71-4c69-8e25-ba838f5f16a3, dosage and administration", "review_status": "reviewed", "verified_against": "ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth 2020 · Egyptian National Drug Formulary - Antimicrobial 2023 (metronidazole monograph)", "verified_date": "2026-08", "treatments": [ { "id": 1709, "generic": "Rifaximin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 550.0, "adult_dose": "550 mg 3 times daily (or 400 mg 3 times daily)", "adult_duration": "14 days", "dose_source": "ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth 2020", "rationale": "Non-absorbable gastrointestinal-targeted antibiotic with minimal systemic side effects", "cautions": [ "Rifaximin is the first-line treatment for hydrogen-predominant SIBO per ACG 2020.", "Address underlying motility or structural cause to prevent high recurrence rate.", "Rifaximin is a non-absorbable antibiotic (<0.4% systemic absorption)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric gastroenterology use only", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "IDIBACT 550 MG 20 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG INDUSTRIES > NOVELL PHARMA", "price_egp": 103.75, "pack_count": 20, "unit_price": 5.19, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ROLAXIMINE 550 MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA > HORUS FOR PHARMACEUTICAL PRODUCTS", "price_egp": 225.0, "pack_count": 30, "unit_price": 7.5, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIFAXEROSE 550 MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AVERROES PHARMA", "price_egp": 82.0, "pack_count": 10, "unit_price": 8.2, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BIOREFAMIN 550 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "P & C LABS > SOVALUE PHARMA", "price_egp": 148.0, "pack_count": 10, "unit_price": 14.8, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUFAXIMIN 550 MG 28 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 480.0, "pack_count": 28, "unit_price": 17.14, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FATROXIM 550 MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > ATM PHARMACEUTICAL INDUSTRIES", "price_egp": 516.0, "pack_count": 30, "unit_price": 17.2, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GASTROBIOTIC 550 MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 516.0, "pack_count": 30, "unit_price": 17.2, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRAVIGUARD 550 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "P AND C LABS > TREND PHARM", "price_egp": 344.0, "pack_count": 20, "unit_price": 17.2, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "small-intestinal-bacterial-overgrowth" }, { "id": 1710, "generic": "Metronidazole", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 250.0, "adult_dose": "250 mg 3 times daily", "adult_duration": "10-14 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (metronidazole monograph)", "rationale": "Alternative systemic antibiotic option for SIBO when rifaximin is unavailable or cost-prohibitive", "cautions": [ "Metronidazole is an alternative for SIBO; it has a higher rate of systemic side effects than rifaximin.", "Avoid alcohol completely during treatment." ], "peds_mgkg_low": 7.5, "peds_mgkg_high": 7.5, "peds_max_mg": 250.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "7.5 mg/kg 3 times daily for 10-14 days", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 75, "high_mg": 75, "capped": false }, { "weight_kg": 20, "low_mg": 150, "high_mg": 150, "capped": false }, { "weight_kg": 30, "low_mg": 225, "high_mg": 225, "capped": false }, { "weight_kg": 40, "low_mg": 250, "high_mg": 250, "capped": true } ], "brands": [ { "trade_name": "TRICHOGYL 250 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 4.35, "pack_count": 20, "unit_price": 0.22, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLAGICURE 250MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 7.0, "pack_count": 20, "unit_price": 0.35, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRICHOCID 250MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 7.0, "pack_count": 20, "unit_price": 0.35, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METRONIDAZOLE-MUP 250 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 11.0, "pack_count": 20, "unit_price": 0.55, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMRIZOLE 250 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 20.0, "pack_count": 20, "unit_price": 1.0, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METROZOLE 250MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 20.0, "pack_count": 20, "unit_price": 1.0, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUMOZOL 125MG/5ML SUSP. 125ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > ALPHARMA-DENMARK", "price_egp": 5.75, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "METROZOLE 125MG/5ML SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 19.5, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "small-intestinal-bacterial-overgrowth" }, { "id": 1711, "generic": "Neomycin", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1000 mg a day by mouth, alongside rifaximin", "adult_duration": "2 weeks", "dose_source": "Small Intestinal Bacterial Overgrowth - StatPearls - NCBI Bookshelf (NBK546634) - the article states the dose for this indication", "rationale": "The card treats every SIBO the same way. Methane-predominant overgrowth responds poorly to rifaximin alone, and the article gives a specific two-drug regimen for it.", "cautions": [ "It is an adjunct to rifaximin for the methane-predominant type, not a treatment on its own.", "Do not exceed two weeks; a little is absorbed and prolonged use risks deafness and kidney damage.", "Contraindicated in intestinal obstruction and in inflammatory or ulcerative bowel disease.", "Reduce or stop it if the kidney function falls, and avoid it in anyone who has reacted badly to another aminoglycoside." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose for this indication in the sources opened; the formulary's paediatric neomycin doses are for hepatic encephalopathy and bowel preparation.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "NEOMYCIN 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 19.0, "pack_count": 20, "unit_price": 0.95, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "small-intestinal-bacterial-overgrowth" }, { "id": 1712, "generic": "Cyanocobalamin", "line": 2, "is_adjunct": true, "form": "injection", "strength_mg": null, "adult_dose": "100 mcg by intramuscular or deep subcutaneous injection daily for six or seven days; the label then lengthens the interval step by step before settling at 100 mcg monthly for life", "adult_duration": null, "dose_source": "Cyanocobalamin DailyMed label, SetID 41ac0dc1-0a71-4c69-8e25-ba838f5f16a3, dosage and administration - verbatim: \"A dose of 100 mcg daily for six or seven days should be administered by intramuscular or deep subcutaneous injection.\"", "rationale": "Low B12 with macrocytic anaemia is the classic laboratory picture of SIBO and it causes real neurological harm. Because the problem is malabsorption, the injection is the route that works.", "cautions": [ "Give it intramuscularly or deep subcutaneously, never intravenously - almost all of an intravenous dose is lost in the urine.", "Contraindicated in anyone sensitive to cobalt or to vitamin B12 itself.", "Confirm the deficiency before treating, and correct the overgrowth as well, or it will come straight back." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose in the sources opened.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "CIDOLVEX 1MG/ML I.M AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 5.2, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BETO-12 1MG/ML 2 AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 11.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RUBIVAMIN 1000 MCG 5 AMPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 42.5, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BETOLVEX 1MG/ML 2 AMPS. I.M.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM", "price_egp": 64.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BETOLVEX 1MG/ML 2 PRE-FILLED SYRINGE I.M.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM", "price_egp": 110.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "small-intestinal-bacterial-overgrowth" } ] }