Positives

• A patient reported the rifaximin/neomycin combination eradicated methane in 87% of subjects vs 33-28% with monotherapy, with 85% achieving clinical response PubMed.
  
  
• A patient who fought SIBO for 2.5 years said a 28-day neomycin-plus-rifaximin course finally cleared symptoms and they would do it again in a heartbeat Mayo Clinic Connect.
  
  

Negatives

• A patient described the first 4 days as worse stools than baseline before improvement, with cramping and nausea common throughout SIBOInfo.
  
  
• A patient noted relapse within months was common, mirroring the up-to-40% recurrence rate seen in studies Beometry.
  
  

Hurdles & Side Effects

• A patient cited insurance denials for rifaximin (Xifaxan) at SIBO indication, with out-of-pocket cost reaching thousands per course VA Formulary.
  
  
• A patient noted neomycin's ototoxicity and nephrotoxicity warnings made some doctors reluctant to prescribe even at low oral doses Mayo Clinic Connect.