Letters To The Editor
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World J Gastroenterol. Apr 14, 2012; 18(14): 1700-1702
Published online Apr 14, 2012. doi: 10.3748/wjg.v18.i14.1700
Rifaximin for the prevention of spontaneous bacterial peritonitis
Georgios N Kalambokis, Athanasia Mouzaki, Maria Rodi, Epameinondas V Tsianos
Georgios N Kalambokis, Epameinondas V Tsianos, The First Division of Internal Medicine and Hepato-Gastroenterology Unit, Medical School of Ioannina, 45110 Ioannina, Greece
Athanasia Mouzaki, Maria Rodi, Division of Hematology, Department of Internal Medicine, Medical School, 26504 Patras, Greece
Author contributions: Kalambokis GN performed the research, analyzed the data, and wrote this letter; Mouzaki A and Rodi M measured plasma endotoxin levels; Tsianos EV was the leading investigator, corrected the manuscript, and was ultimately responsible for the data and its use.
Correspondence to: Epameinondas V Tsianos, MD, PhD, AGAF, FEBG Professor of Internal Medicine, The First Division of Internal Medicine and Hepato-Gastroenterology Unit, Medical School of Ioannina, 45110 Ioannina, Greece. etsianos@cc.uoi.gr
Telephone: +30-26-51097501 Fax: +30-26-51097016
Received: October 19, 2011
Revised: February 20, 2012
Accepted: February 26, 2012
Published online: April 14, 2012
Abstract

According to a review article by Biecker et al published in a previous issue of World Journal of Gastroenterology in March 2011, intestinal decontamination with norfloxacin remains the mainstay of primary prophylaxis of spontaneous bacterial peritonitis (SBP) at the expense of development of quinolone-resistant bacteria after long-term use. In our research, the administration of a 4-wk regimen with rifaximin 1200 mg/d reduced significantly the ascitic neutrophil count in cirrhotic patients with sterile ascites in line with a significant decrease in plasma endotoxin levels. Our observations concur with recent findings, showing a significantly reduced 5-year probability of SBP in cirrhotic patients taking rifaximin.

Keywords: Rifaximin; Cirrhosis; Ascites; Spontaneous bacterial peritonitis