Rifaximin Use Is Associated With Prognosis and Recurrence Patterns in Spontaneous Bacterial Peritonitis: Exploratory...

Area of Science:

• Hepatology
• Gastroenterology
• Infectious Diseases

Background:

• Spontaneous bacterial peritonitis (SBP) is a severe complication in cirrhotic patients with refractory ascites.
• Limited data exists on rifaximin (RFX) for SBP prevention and prognosis in Japan.
• The oral-gut-hepatic axis role in cirrhosis prognosis is under investigation.

Purpose of the Study:

• To investigate the effect of RFX on SBP recurrence and prognosis in cirrhotic patients.
• To evaluate the prognostic significance of oral health in the context of the oral-gut-hepatic axis.
• To assess RFX efficacy in a Japanese cohort with refractory ascites.

Main Methods:

• Retrospective single-center study of 142 patients with a first SBP episode.
• Patients were divided into RFX-treated and non-RFX groups.
• Outcomes analyzed: 90-day survival, SBP recurrence, cirrhosis complications, oral health, and acid-suppressive therapy.

Main Results:

• RFX group showed higher 90-day survival (85.1% vs. 60.0%) and lower 12-month SBP recurrence (10.4% vs. 63.2%).
• RFX-treated patients had fewer enteric bacteria and more oral flora in ascitic fluid.
• Oral contamination predicted hepatic encephalopathy and variceal rupture; denture use predicted mortality.

Conclusions:

• RFX use is linked to improved survival and reduced SBP recurrence in cirrhotic patients with refractory ascites.
• Oral contamination and denture use are associated with adverse outcomes, highlighting the oral-gut-hepatic axis.
• Combining RFX therapy with oral hygiene interventions may enhance cirrhosis prognosis.