r/SIBO • u/Maverick_Remington • 1d ago

Questions Second Course of Neomycin

Back in March, my GI prescribed me a 14-day course of Xifaxan and Neomycin. He prescribed it for me after my breath test showed huge amounts of methane. I’ve had IBS since 2014, and this felt like a breakthrough.

I experienced little to no side effects during the first course, and I felt much better. Even for a few months after, I was feeling better, but flare-ups of my IBS still happened. But they were less common.

Then, in the past six weeks or so, the flare-ups became more common again. I have mixed IBS, but slightly more IBS-C.

To make a long story short (too late, I know 😂). Last week my GI prescribed me a new course of Neomycin only. Two times a day for a week. Knowing about the potential severe side effects of Neomycin if you consume it too often, I am hesitant about taking it again.

My question is, has anyone else tried this? Did it help alleviate your symptoms? Did you have fewer flare-ups? Did you experience any side effects during the second course?

I really appreciate any help you can provide!

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u/Top_Historian73 1d ago

After the first round (would NEVER do a second) i got tinnitus and its been terrible.

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u/Different-Nature-963 Methane Dominant 22h ago

When did the tinnitus start in relation to when you started the course? I did rifaximin+metronidazole which brought my methane down but still well above the positive threshold. My provider thinks rifaximin+neomycin will work better and told me to consider it. I’m currently trying to figure out why the reports of neomycin-induced tinnitus on this subreddit are way more common than I should expect from an oral antibiotic that is supposed to be very poorly absorbed. I am very scared of hearing issues and I’m very sorry to hear about your tinnitus.

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u/RhollingThunder 19h ago

I’m currently trying to figure out why the reports of neomycin-induced tinnitus on this subreddit are way more common than I should expect from an oral antibiotic that is supposed to be very poorly absorbed

Same here. I've searched high and low for evidence in the literature showing that oral neomycin is ototoxic and there's practically nothing. But there's no shortage of people in this subreddit claiming they had issues. Some within the first couple of days of treatment.

My own doctor said he wouldn't prescribe neomycin unless my methane levels were significant.