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Safety and Efficacy of Rifaximin in Prophylaxis of Spontaneous Bacterial Peritonitis: A Systematic Review and Meta-analysis

[ Vol. 20 , Issue. 4 ]

Author(s):

Amr Menshawy, Omar Mattar, Kirolos Barssoum, Ammar M. AboEl-Naga, Haitham Mohamed Salim, Ahmed Mesbah Fahmy Mohamed, Ahmed Elgebaly and Sherief Abd-Elsalam*   Pages 380 - 387 ( 8 )

Abstract:


Aim: The role of rifaximin in the prevention of Spontaneous Bacterial Peritonitis (SBP) is not well studied. The aim of this meta-analysis was to evaluate the role of rifaximin in the prevention of SBP.

Methods: A computerized literature search for relevant clinical trials was conducted during August 2017. Data on Frequency of SBP, the success rate of prevention of SBP, mortality rate, hepatorenal syndrome, septic shock, hepatic encephalopathy, and GIT bleeding were extracted and pooled as Risk Ratio (RR) with their 95% Confidence Interval (CI) in a meta-analysis model. Heterogeneity was assessed by Chi-square test.

Results: Six studies involving 973 patients were included in the final analysis. The pooled effect estimate showed that the rifaximin plus norfloxacin group had less incidence of SBP (RR 0.58, 95% CI[0.37, 0.92], P=0.02) and hepatic encephalopathy (RR 0.38, 95% CI[0.17, 0.84], P=0.02) than the norfloxacin-based regimen group. No significant difference between rifaximin and norfloxacin in terms of frequency of SBP and success rate of primary prevention of SBP (RR 0.49, 95% CI [0.24, 1.01], P=0.05; RR1.21, 95% CI [0.95, 1.55], P=0.13, respectively).

Conclusion: Based on our analysis, Rifaximin is a promising drug and appears to be a good alternative to norfloxacin in the prevention of SBP.

Keywords:

Rifaximin, norfloxacin, SBP, encephalopathy, prevention, hepatorenal syndrome.

Affiliation:

Medical Research Education and Practice Association (MREP), Cairo, Medical Research Education and Practice Association (MREP), Cairo, Medical Research Education and Practice Association (MREP), Cairo, Medical Research Education and Practice Association (MREP), Cairo, Medical Research Education and Practice Association (MREP), Cairo, Medical Research Education and Practice Association (MREP), Cairo, Medical Research Education and Practice Association (MREP), Cairo, Department of Tropical Medicine & Infectious Diseases, Faculty of Medicine, Tanta University, Tanta

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