Comparison of Rifaximin with Norfloxacini in the Primary Prophylaxiso of Spontaneous Bacterial Peritonitis

Abstract

Objective: To compare the efficacy of Rifaximin vs Norfloxacin in preventing episode of
spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis.
Methods: It was randomized Controlled Trial conducted at Department of Gastroenterology,
Services Hospital, Lahore from 15-09-2015 to 14-03-2016. One hundred patients of both gender
in the age range 18-60 with 50 patients in Rifaximin group and 50 patients in Norfloxacin group.
Patients after informed consent were randomly assigned to one of the two groups and received
prophylaxis for SBP with Rifaximin (1100mg/day) or Norfloxacin (400mg/day) using random
tables. Patients were followed up after four weeks and outcome was efficacy in terms of
prevention of episode of SBP and was assessed as per operational definition.
Results: A total of 100 patients were included in the study. The mean age of patients was 46.40(±
5.78) years with most of the patients in the age range 31-45 years. Majority of the patients in the
study were male (54.0%). Mean polymorphonuclear (PMN) count was 144.4±25.8. Only 7
patients developed SBP, 4 were in Norfloxacin group and 3 were in Rifxaimin group showing
efficacy of 92% and 96% respectively with no statistically significant difference(p value >0.05).
Stratification of patients by Age, Gender, Duration of disease and Child Pugh score showed p
value was >0.05 in all cases showing statistically insignificant difference between various
subgroups.
Conclusions: The study shows that rifaximin is as effective as Norfloxacin when used for SBP
prophylaxis in cirrhotic patients with ascites.