Background/purpose of the study
Spontaneous bacterial peritonitis (SBP) is a cause of significantly higher morbidity
and mortality in patients with cirrhosis. This study was conducted to assess the
effect of adding rifaximin to cefotaxime in treatment of SBP.
Materials and methods
The study was a prospective one that involved 98 patients with cirrhosis with SBP,
who were divided randomly into two equal groups. Patients in group I received
cefotaxime, whereas patients in group II received a combination of cefotaxime and
rifaximin. Patients were evaluated clinically, and diagnostic aspiration was repeated
on the third day of antibiotic therapy.
Both groups showed significant reduction in white blood cells on the third day
compared with the first day (P<0.0001). Polymorphonuclear leukocyte count in
ascetic fluid in both groups showed significant reduction on the third day compared
with the first day, and the reduction was statistically significant in group II compared
with group I (P<0.0001). One the third day of therapy, serum creatinine levels in
group I and group II were 1.61±0.19 and 1.28±0.37, respectively. Both groups
showed significant decrease in serum creatinine level. The reduction in group II
compared with group I was statistically significant, with P value less than 0.0001.
Rifaximin plus cefotaxime showed some favorable effects in treatment of SBP than
cefotaxime alone. However, the clinical effects of these effects need to be clarified
in further studies.