Aim: The role of rifaximin in the prevention of Spontaneous Bacterial Peritonitis (SBP) is
not well studied. The aim of this meta-analysis was to evaluate the role of rifaximin in the prevention
Methods: A computerized literature search for relevant clinical trials was conducted during August
2017. Data on Frequency of SBP, the success rate of prevention of SBP, mortality rate, hepatorenal
syndrome, septic shock, hepatic encephalopathy, and GIT bleeding were extracted and pooled as Risk
Ratio (RR) with their 95% Confidence Interval (CI) in a meta-analysis model. Heterogeneity was assessed
by Chi-square test.
Results: Six studies involving 973 patients were included in the final analysis. The pooled effect estimate
showed that the rifaximin plus norfloxacin group had less incidence of SBP (RR 0.58, 95%
CI[0.37, 0.92], P=0.02) and hepatic encephalopathy (RR 0.38, 95% CI[0.17, 0.84], P=0.02) than the
norfloxacin-based regimen group. No significant difference between rifaximin and norfloxacin in
terms of frequency of SBP and success rate of primary prevention of SBP (RR 0.49, 95% CI [0.24,
1.01], P=0.05; RR1.21, 95% CI [0.95, 1.55], P=0.13, respectively).
Conclusion: Based on our analysis, Rifaximin is a promising drug and appears to be a good alternative
to norfloxacin in the prevention of SBP.