Rifaximin as a Prophylaxis of Spontaneous Bacterial Peritonitis in Comparison with Ciprofloxacin

Background: Among those hospitalized with liver cirrhosis, spontaneous bacterial peritonitis (SBP) is one of the most frequently occurring infections. Its diagnosis depends on the polymorphonuclear cell (PMN) number within the infected fluid (≥ 250 cells/μL). The survivors of cirrhotic liver disease following SBP episodes must be treated with prolonged prophylaxis.Aim of the Work: To evaluate Rifaximin efficacy as a SBP prophylaxis compared to ciprofloxacin.Methods: This randomized controlled trial was performed on two groups of cirrhotic liver disease Egyptian patients with ascites post-SBP attacks. Group (1) included 40 patients who were administered Rifaximin at a 550 mg twice daily dosage for six months, and group (2) included 40 patients who were administered Ciprofloxacin at a 750 mg once weekly dose for six months. All patients in the two groups were followed up for recurrence of SBP for six months.Results: We had seven patients with recurrent attacks of SBP in group (1); the percentage was 17.5%, and in group (2), there were nine patients with recurrences of SBP with a percentage of 22.5% (with a P value of 0.295). Both studied groups have shown no significant difference (P< 0.05).Conclusion: Rifaximin can be used as a prophylaxis for SBP and is as effective as Ciprofloxacin.