Observational studyLiver international : official journal of the International Association for the Study of the Liver2022
Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH).
Observational study in Liver international : official journal of the International Association for the Study of the Liver, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05786859 (The Efficacy and Safety of Rifaximin In The Treatment of HBV Associated Acute-on-Chronic Liver Failure Patients With Mild to Moderate Hepatic Encephalopathy), which is not on this map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Efficacy and Safety of Rifaximin In The Treatment of HBV Associated Acute-on-Chronic Liver Failure Patients With Mild to Moderate Hepatic Encephalopathy
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Beyond corticosteroids: A systematic review of novel therapeutic strategies in severe alcoholic hepatitis and 90-day survival.World journal of gastroenterology · 2025Pooled it
- Past, Present, and Future Therapies for Alcohol-associated Hepatitis.Clinical therapeutics · 2023Pooled it
- Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2023Pooled it
- Gut microbial dynamics and antibiotic resistance during rifaximin therapy in severe cirrhosis: a ProPILA-Rifax ancillary study.Frontiers in cellular and infection microbiology · 2026Trial
- Trial
- Acute-on-chronic liver failure: pathophysiological mechanisms and clinical management.Nature reviews. Gastroenterology & hepatology · 2026Review
- Current Clinical Trials for Alcohol-Associated Hepatitis.The American journal of pathology · 2026Review
- Ferroptosis and gut microbiota: A new horizon in alcohol-associated liver disease management.Cellular and molecular life sciences : CMLS · 2025Review
- Acute alcohol-associated hepatitis: Latest findings in non-invasive biomarkers and treatment.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Alcohol-associated liver disease: Natural history, management and novel targeted therapies.Clinical and molecular hepatology · 2025Review
- Alcohol-related liver disease.Gastroenterology report · 2025Review
- Novel therapeutic effects of rifaximin in combination with methylprednisolone for LPS-induced oxidative stress and inflammation in mice: AnToxicology reports · 2024Article
- Bacterial Infection Features in Alcohol-Associated Hepatitis: Review of a 2016-2021 Cohort.Journal of clinical medicine · 2024Article
- Bacterial Infections in Acute-on-chronic Liver Failure: Epidemiology, Diagnosis, Pathogenesis, and Management.Journal of clinical and translational hepatology · 2024Review
- Impact of rifaximin use in infections and mortality in patients with decompensated cirrhosis and hepatic encephalopathy.Therapeutic advances in gastroenterology · 2024Article
- Improving survival in alcohol-related hepatitis: what's new?Frontline gastroenterology · 2024Review
- Advances in the management of alcohol-associated liver disease.Gastroenterology report · 2024Review
- Alcohol-related liver disease (ALD): current perspectives on pathogenesis, therapeutic strategies, and animal models.Frontiers in pharmacology · 2024Review
- Intestinal Microbiotas and Alcoholic Hepatitis: Pathogenesis and Therapeutic Value.International journal of molecular sciences · 2023Review
- Therapeutic targets in alcohol-associated liver disease: progress and challenges.Therapeutic advances in gastroenterology · 2023Review
Corrections and comments
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Authors and funding
26 authors.
Funding
Abstract
BACKGROUND &
aimsAlcoholic hepatitis (AH) is associated with a high incidence of infection and mortality. Rifaximin reduces bacterial overgrowth and translocation. We aimed to study whether the administration of rifaximin as an adjuvant treatment to corticosteroids decreases the number of bacterial infections at 90 days in patients with severe AH compared to a control cohort.
methodsThis was a multicentre, open, comparative pilot study of the addition of rifaximin (1200 mg/day/90 days) to the standard treatment for severe AH. The results were compared with a carefully matched historical cohort of patients treated with standard therapy and matching by age and model of end-stage liver disease (MELD). We evaluated bacterial infections, liver-related complications, mortality and liver function tests after 90 days.
resultsTwenty-one and 42 patients were included in the rifaximin and control groups respectively. No significant baseline differences were found between groups. The mean number of infections per patient was 0.29 and 0.62 in the rifaximin and control groups, respectively (p = .049), with a lower incidence of acute-on-chronic liver failure (ACLF) linked to infections within the treatment group. Liver-related complications were lower within the rifaximin group (0.43 vs. 1.26 complications/patient respectively) (p = .01). Mortality was lower in the treated versus the control groups (14.2% vs. 30.9, p = .15) without significant differences. No serious adverse events were associated with rifaximin treatment.
conclusionsRifaximin is safe in severe AH with a significant reduction in clinical complications. A lower number of infections and a trend towards a lower ACLF and mortality favours its use in these patients.
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