Effect of rifaximin on gut microbiota composition in advanced liver disease and its complications

Table 2 Major studies describing the efficacy of rifaximin in preventing episodes of spontaneous bacterial peritonitis in patients with advanced liver disease

Study	Study design	No. patients	Disease severity	Disease complication	Treatment schedule	Results	Safety
Hanouneh et al[66] 2012	Retrospective	404	MELD score (mean ± SD):	SBP	49 pts received rifaximin	SBP incidence: 11% in pts on rifaximin vs 32% in controls (P = 0.002)	Not reported
			rifaximin: 17.6 ± 7.7		400 mg TID mainly for HE
			no rifaximin 17.7 ± 7.5		(recurrent HE or intolerance to lactulose)	72% SBP reduction rate in rifaximin group after adjusting for MELD score, CTP score, serum sodium, and ascitic fluid total proteins (P = 0.007)
			CTP score
			rifaximin B: 6.1%, C: 93.9%
			no rifaximin B: 33%, C: 67%
						72% transplant-free survival for pts on rifaximin vs 57% for controls (P = 0.045)
Lutz et al[69] 2014	Prospective, observational	152	CTP score:	SBP	Group 1 (108 pts): no prophylaxis	SBP occurrence rate: 32/152 (21%) overall, 22.2% group 1, 29.6% group 2 and 0% group 3 (P = 0.02 group 2 vs group 3 and P = 0.04 group 1 vs group 3)	Data available for SBP pts only
			no prophylaxis:				Nosocomial infections: 38% rifaximin vs 54% no rifaximin (P = 0.690)
			A: 1%, B: 57%, C: 43%		Group 2 (27 pts): rifaximin 400 mg TID
			rifaximin:				Isolation of bacteria resistant to III generation cephalosporin: 25% rifaximin vs 46% no rifaximin
			A: 0%, B: 33%, C: 67%		Group 3 (17 pts): systemically absorbed antibiotic prophylaxis
			systemically absorbed antibiotics:
			A:12%, B: 47%, C: 41%				Isolation of multidrug resistant bacteria: 25% rifaximin vs 9% no rifaximin

SBP: Spontaneous bacterial peritonitis; CTP: Child turcotte pugh.