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However, even when the subjects studied did not have bacterial overgrowth, a randomized control trial of neomycin given for just 10 days showed a transient improvement 1 week after treatment ceased, an effect which was greatest for those whose breath hydrogen fell the most. Others have also reported transient symptomatic benefit with antibiotics such as metronidazole. The mechanism of benefit is unclear, but may be similar to that seen in diets that exclude sources of poorly absorbed carbohydrate, which have been shown to lead to a reduction in 24-h hydrogen and methane gas excretion. However, antibiotic treatments seem unlikely to be useful, as symptoms promptly return on stopping antibiotics and chronic antibiotic therapy is invariably associated with the development of bacterial resistance. Furthermore, other authors have suggested that the consumption of antibiotics actually increases the risk of subsequently developing IBS symptoms.

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