Impact of rifaximin use in infections and mortality in patients with decompensated cirrhosis and hepatic encephalopathy

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dc.article.number105030
dc.contributor.authorIdalsoaga F.
dc.contributor.authorRobles C.
dc.contributor.authorOrtiz A.
dc.contributor.authorCorsi O.
dc.contributor.authorFuentes-Lopez E.
dc.contributor.authorDiaz L.A.
dc.contributor.authorAyares G.
dc.contributor.authorArrese M.
dc.contributor.authorArab J.P.
dc.date.accessioned2024-10-15T07:00:10Z
dc.date.available2024-10-15T07:00:10Z
dc.date.issued2024
dc.description.abstract© The Author(s), 2024.Introduction: Infections in patients with cirrhosis are associated with high morbidity and mortality. Rifaximin is an antibiotic used to treat and prevent hepatic encephalopathy (HE); however, it has been suggested that it may play a crucial role in reducing infections in these populations. Aim: To evaluate the role of rifaximin in preventing frequent cirrhosis-related infections [spontaneous bacterial peritonitis, pneumonia, urinary tract infection (UTI), and bacteremia], Clostridioides difficile infection, and all-cause mortality, as well as determining adverse effects and adherence to the drug. Methods: A retrospective cohort study was conducted on decompensated cirrhotic patients with history of HE between January 2017 and November 2022 at a university center. Patients with cirrhosis, regardless of their etiology and severity, were included in the study, encompassing both hospitalized and outpatient cases. The statistical analysis included adjusted general linear models, Poisson regressions, and propensity score matching. Results: We included 153 patients. The mean age in the cohort was 60.2 ± 12.3 years and 67 (43.8%) were women. The main cause of cirrhosis was metabolic dysfunction-associated steatotic liver disease 52 (38%), and the median Model of End-Stage Liver Disease sodium was 16.5 (7–32). In the cohort, 65 (45%) patients used rifaximin. The mean follow-up was 32 months. Eighty-five patients with infectious events were recorded, and a total of 164 infectious events were registered. The main infectious events were UTIs (62, 37.8%) and pneumonia (38, 23.2%). The use of rifaximin was associated with lower infection rates, displaying an incidence rate ratio (IRR) of 0.64 [95% confidence interval (CI) (0.47–0.89); p = 0.008]. However, no discernible impact on mortality outcome was observed [IRR 1.9, 95% CI (0.9–4.0); p = 0.09]. There were no reported adverse effects, and no patient discontinued the therapy due to adverse effects. Conclusion: The use of rifaximin significantly reduces infections in patients with cirrhosis and HE. Despite rifaximin was associated with a decreased all-cause mortality, this impact was not statistically significant in the adjusted analysis.
dc.description.funderFONDECYT
dc.description.funderFONDECYT
dc.format.extent559 páginas
dc.fuente.origenScopus
dc.identifier.doi10.1177/17562848241254267
dc.identifier.eissn17482801
dc.identifier.issn17562848 1756283X
dc.identifier.pubmedid35430032
dc.identifier.scopusidSCOPUS_ID:85194746390
dc.identifier.urihttps://doi.org/10.1177/17562848241254267
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/88221
dc.identifier.wosidWOS:001234053700001
dc.information.autorucFacultad de Medicina; Fuentes Lopez, Eduardo; S/I; 1013849
dc.issue.numero6
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final20
dc.pagina.inicio14
dc.relation.ispartofThe Lancet Gastroenterology and Hepatology
dc.revistaTherapeutic Advances in Gastroenterology
dc.rightsacceso abierto
dc.subjectcirrhosis
dc.subjecthepatic encephalopathy
dc.subjectinfections
dc.subjectrifaximin
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleImpact of rifaximin use in infections and mortality in patients with decompensated cirrhosis and hepatic encephalopathy
dc.typeartículo
dc.volumen17
sipa.codpersvinculados1013849
sipa.indexScopus
sipa.trazabilidadCarga WOS-SCOPUS;15-10-2024
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