Is there such a thing as rifaximin failure?

Unfortunately, yes. Approximately 10-15% of the children under Dr. Nemechek’s care for autism do not respond to rifaximin in any manner. The numbers are roughly the same for adults under Dr. Nemechek’s supervision. nnDr. Nemechek believes the main reason is that in the case of this small percentage of children, the bacterial overgrowth IS NOT from colonic bacteria (fish), as portrayed in his book. Recent studies in adults have discovered that the bacteria in almost 20% of individuals with SIBO comes from the mouth and throat (oropharynx) and not the colon. This information came to light after the publication of the 2nd edition of Dr. Nemechek’s book.nnRifaximin has NO EFFECT on bacteria that originate from the oropharynx, and as such, children who are overgrown with oropharyngeal bacteria will not respond to rifaximin.nnDr. Nemechek is presently working through the best and safest approach to this problem with a group of children that did not improve with rifaximin. Despite some successes, Dr. Nemechek recommends that children seek the assistance of local gastroenterologists for help with the treatment of bacterial overgrowth.