Norfloxacin versus rifaximin for spontaneous bacterial peritonitis prophylaxis: A randomized controlled trial
Year: 2024
Type: article
Study design: Clinical Trial
Abstract: Background: Spontaneous Bacterial Peritonitis (SBP) is a bacterial infection of ascitic fluid occurring in patients suffering from cirrhosis and ascites exhibiting high short-term mortality rate and poor long-term prognosis. Aim and Objectives: Diagnosis based on ascitic fluid polymorphonuclear neutrophil count and culture was carried out. Norfloxacin is the current first-line prophylactic antibiotic treatment for SBP. The study aimed to compare the efficacy of norfloxacin and rifaximin in preventing SBP in patients with cirrhosis and ascites. Material and Methods: Total 66 patients were included, with 33 patients in each group. Patients in first group were administered 400 mg norfloxacin twice daily per orally, while other group was administered rifaximin 400 mg twice daily per orally for 3 months. The patients were followed up every month for three months to evaluate the signs and symptoms of SBP and other complications related to cirrhosis. Results: Mean age of all patients was 48.48 ± 10.44 years with majority being male. The most reported symptoms were decreased appetite and generalized weakness, while the most common sign detected was abdominal distention. Alcoholic liver disease was the most common etiology among patients with SBP. Hematological and biochemical parameters differed less significantly between two treatment groups, except for international normalized ratio values. At first, second and third follow-ups, more patients from norfloxacin administered group reported hepatic encephalopathy, gastrointestinal bleed, hepatorenal syndrome and SBP episodes than from rifaximin administered group. Conclusion: Overall, the study highlights effectiveness of rifaximin over norfloxacin in reducing the risk of complications in cirrhosis patients with ascites and Child Pugh Score > 9.
Authors: Sanbanki Pala, Purwa Doke, Dadasaheb Maindad
Institution: Bharati Vidyapeeth (Deemed to be University)
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7049232706