|Title:||Impact of rifaximin use for hepatic encephalopathy on the risk of early post-transplant infections in liver transplant recipients||Authors:||Sun, Hsin-Yun
Cacciarelli, Thomas V.
|Issue Date:||2012||Journal Volume:||26||Journal Issue:||6||Start page/Pages:||849-852||Source:||Clinical Transplantation||Abstract:||
Background: Whether the use of rifaximin for hepatic encephalopathy during liver transplant candidacy has an impact on post-transplant infections is not known. Methods: We compared the frequency and spectrum of infections within 90 d post-transplant in liver transplant recipients who did and did not receive rifaximin for hepatic encephalopathy during transplant candidacy. Results: Of 110 consecutive liver transplant recipients, 30 (27%) received rifaximin. Rifaximin users were more severely ill based on higher Model for End-Stage Liver Disease (MELD) score (p = 0.005). When controlled for MELD (stratified by MELD < 30, MELD ? 30), the risk of infections was significantly lower in rifaximin vs. no rifaximin recipients (OR = 0.269, 95% CI 0.078-0.0.934, p = 0.026). Rifaximin use was not associated with a higher risk of multidrug resistant bacterial infections (OR = 1.8, 95% CI 0.42-8.35, p = 0.40). The probability of post-transplant survival at 90 d did not differ for patients with or without rifaximin use (0.90 for both groups, p = 0.56). Conclusions: Rifaximin appeared to have a protective effect against early post-transplant infections in more severely ill liver transplant recipients. Rifaximin use did not select for multidrug resistant bacteria in these patients. ? 2012 John Wiley & Sons A/S.
|DOI:||10.1111/j.1399-0012.2012.01619.x||metadata.dc.subject.other:||amphotericin B; corticosteroid; cotrimoxazole; methylprednisolone; micafungin; rifaximin; tacrolimus; adult; article; bacteremia; bacterial infection; drug efficacy; female; graft recipient; graft rejection; hepatic encephalopathy; human; immunosuppressive treatment; infection complication; infection risk; liver failure; liver graft; low drug dose; major clinical study; male; multidrug resistance; mycosis; pneumocystosis; postoperative infection; priority journal; renal replacement therapy; risk assessment; survival rate; Aged; Anti-Infective Agents; End Stage Liver Disease; Female; Follow-Up Studies; Graft Rejection; Hepatic Encephalopathy; Humans; Infection; Liver Transplantation; Male; Middle Aged; Postoperative Complications; Prognosis; Rifamycins; Risk Factors; Survival Rate
|Appears in Collections:||醫學系|
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