Trial reportFrontiers in cellular and infection microbiology2026
Gut microbial dynamics and antibiotic resistance during rifaximin therapy in severe cirrhosis: a ProPILA-Rifax ancillary study.
Trial report in Frontiers in cellular and infection microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03069131 (A Multicenter, Double-blind, Placebo-controlled Randomized Clinical Trial Comparing Two Strategies of Primary Prophylaxis of Spontaneous Bacterial Peritonitis in Severe Cirrhotic Patients With Ascites), which is not on this map. Not yet cited in PubMed.
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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.
A Multicenter, Double-blind, Placebo-controlled Randomized Clinical Trial Comparing Two Strategies of Primary Prophylaxis of Spontaneous Bacterial Peritonitis in Severe Cirrhotic Patients With Ascites : Using or Not Using Rifaximin
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Authors and funding
12 authors.
Funding
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Abstract
Introduction: Increasing evidence implicates gut dysbiosis in the pathophysiology of advanced cirrhosis. This is an ancillary study of the ProPILA-Rifax trial (NCT03069131), which evaluated rifaximin (RFX) as primary prophylaxis of spontaneous bacterial peritonitis (SBP) in patients with severe cirrhosis. Although the combined use of RFX and lactulose is effective in preventing recurrent hepatic encephalopathy (HE), its longitudinal impact on microbial communities and antibiotic resistance remains poorly characterized. Methods: We characterized longitudinal changes in the gut microbiome of 42 patients (21 RFX, 21 placebo) over 12 months using 16S rRNA gene sequencing and culture-based phenotypic susceptibility testing. Exploratory analyses between patient bacterial profiles and clinical outcomes (disease severity, overall survival, and incidence of SBP) were conducted. Results: RFX treatment reduced microbial richness and decreased the abundance of taxa typically enriched in advanced cirrhosis (e.g., Discussion: In severe cirrhosis, RFX profoundly alters gut microbial composition by reducing pathobiont abundance while promoting rifampicin resistance in
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