Prevalence and risk of small intestinal bacterial overgrowth in patients with rosacea: A systematic review and meta-analysis; Распространенность и риск синдрома избыточного бактериального роста в тонкой кишке у пациентов с розацеа: систематический обзор и метаанализ

Aim. To systematize data on the prevalence and risk of small intestinal bacterial overgrowth (SIBO) in patients with rosacea. Materials and methods. The search for studies was conducted in the MEDLINE/PubMed, EMBASE, and the Russian Science Citation Index from January 1, 1985, to April 5, 2025. The inclusion criteria were original clinical studies in English or Russian with detailed descriptive statistics describing the prevalence of SIBO in adults with rosacea. The analysis included an assessment of the SIBO prevalence, calculation of relative risk, and 95% confidence interval (CI) using a random effects model. Heterogeneity was assessed using I2-statistics, and publication bias was examined with funnel plots and Begg–Mazumdar and Egger tests. Results. The meta-analysis included 6 studies with 801 subjects (581 subjects with rosacea, 220 controls). The overall prevalence of SIBO in patients with rosacea was 35.8% (95% CI 23.626–48.985) compared to 9.391% (95% CI 4.256–16.265) in controls. The risk of developing SIBO in patients with rosacea was 3.501 times higher (relative risk 3.50; 95% CI 1.347–9.100; p=0.012). Treatment with rifaximin (1200 mg/day for 10 days) resulted in significant improvement or remission of rosacea in 57.9% (95% CI 49.5–66.3) of patients, with the highest effectiveness (up to 85.7%) observed in those with successful eradication of SIBO. Conclusion. The results of a systematic review and meta-analysis confirm the potential association between SIBO and rosacea and demonstrate the effectiveness of rifaximin in treating cutaneous manifestations of rosacea in these patients. It is necessary to consider SIBO diagnosis when assessing patients with rosacea, especially in resistant forms of the disease. © 2025 Elsevier B.V., All rights reserved.