Impact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.

<h4>Background</h4>Rifaximin is a non-absorbable antibiotic used to prevent relapses of hepatic encephalopathy which may also be a candidate for prophylaxis of spontaneous bacterial peritonitis (SBP).<h4>Aim</h4>To detect the impact of rifaximin on the occurrence and characte...

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Autores principales:	Philipp Lutz, Marijo Parcina, Isabelle Bekeredjian-Ding, Hans Dieter Nischalke, Jacob Nattermann, Tilman Sauerbruch, Achim Hoerauf, Christian P Strassburg, Ulrich Spengler
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8cd9dded5b86494ba2b13a480605d88d
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spelling	oai:doaj.org-article:8cd9dded5b86494ba2b13a480605d88d2021-11-18T08:24:30ZImpact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.1932-620310.1371/journal.pone.0093909https://doaj.org/article/8cd9dded5b86494ba2b13a480605d88d2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24714550/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Rifaximin is a non-absorbable antibiotic used to prevent relapses of hepatic encephalopathy which may also be a candidate for prophylaxis of spontaneous bacterial peritonitis (SBP).<h4>Aim</h4>To detect the impact of rifaximin on the occurrence and characteristics of SBP.<h4>Methods</h4>We prospectively studied all hospitalized patients that underwent a diagnostic paracentesis in our department from March 2012 to April 2013 for SBP and recorded all clinical data including type of SBP prophylaxis, prior use of rifaximin, concomitant complications of cirrhosis, as well as laboratory results and bacteriological findings. Patients were divided into the following three groups: no antibiotic prophylaxis, prophylaxis with rifaximin or with systemically absorbed antibiotic prophylaxis.<h4>Results</h4>Our study cohort comprised 152 patients with advanced liver cirrhosis, 32 of whom developed SBP during the study period. As expected, our study groups differed regarding a history of hepatic encephalopathy and SBP before inclusion into the study. None of the 17 patients on systemic antibiotic prophylaxis developed SBP while 8/27 patients on rifaximin and 24/108 without prophylaxis had SBP (p = 0.02 and p = 0.04 versus systemic antibiotics, respectively). In general, episodes of SBP were similar for patients treated with rifaximin and those without any prophylaxis. However, Escherichia coli and enterococci were dominant in the ascites of patients without any prophylaxis, while mostly klebsiella species were recovered from the ascites samples in the rifaximin group.<h4>Conclusion</h4>Rifaximin pretreatment did not lead to a reduction of SBP occurrence in hospitalized patients with advanced liver disease. However, the bacterial species causing SBP were changed by rifaximin.Philipp LutzMarijo ParcinaIsabelle Bekeredjian-DingHans Dieter NischalkeJacob NattermannTilman SauerbruchAchim HoeraufChristian P StrassburgUlrich SpenglerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e93909 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Philipp Lutz Marijo Parcina Isabelle Bekeredjian-Ding Hans Dieter Nischalke Jacob Nattermann Tilman Sauerbruch Achim Hoerauf Christian P Strassburg Ulrich Spengler Impact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.
description	<h4>Background</h4>Rifaximin is a non-absorbable antibiotic used to prevent relapses of hepatic encephalopathy which may also be a candidate for prophylaxis of spontaneous bacterial peritonitis (SBP).<h4>Aim</h4>To detect the impact of rifaximin on the occurrence and characteristics of SBP.<h4>Methods</h4>We prospectively studied all hospitalized patients that underwent a diagnostic paracentesis in our department from March 2012 to April 2013 for SBP and recorded all clinical data including type of SBP prophylaxis, prior use of rifaximin, concomitant complications of cirrhosis, as well as laboratory results and bacteriological findings. Patients were divided into the following three groups: no antibiotic prophylaxis, prophylaxis with rifaximin or with systemically absorbed antibiotic prophylaxis.<h4>Results</h4>Our study cohort comprised 152 patients with advanced liver cirrhosis, 32 of whom developed SBP during the study period. As expected, our study groups differed regarding a history of hepatic encephalopathy and SBP before inclusion into the study. None of the 17 patients on systemic antibiotic prophylaxis developed SBP while 8/27 patients on rifaximin and 24/108 without prophylaxis had SBP (p = 0.02 and p = 0.04 versus systemic antibiotics, respectively). In general, episodes of SBP were similar for patients treated with rifaximin and those without any prophylaxis. However, Escherichia coli and enterococci were dominant in the ascites of patients without any prophylaxis, while mostly klebsiella species were recovered from the ascites samples in the rifaximin group.<h4>Conclusion</h4>Rifaximin pretreatment did not lead to a reduction of SBP occurrence in hospitalized patients with advanced liver disease. However, the bacterial species causing SBP were changed by rifaximin.
format	article
author	Philipp Lutz Marijo Parcina Isabelle Bekeredjian-Ding Hans Dieter Nischalke Jacob Nattermann Tilman Sauerbruch Achim Hoerauf Christian P Strassburg Ulrich Spengler
author_facet	Philipp Lutz Marijo Parcina Isabelle Bekeredjian-Ding Hans Dieter Nischalke Jacob Nattermann Tilman Sauerbruch Achim Hoerauf Christian P Strassburg Ulrich Spengler
author_sort	Philipp Lutz
title	Impact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.
title_short	Impact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.
title_full	Impact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.
title_fullStr	Impact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.
title_full_unstemmed	Impact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.
title_sort	impact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/8cd9dded5b86494ba2b13a480605d88d
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Impact of rifaximin on the frequency and characteristics of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.

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