Increased risk of antimicrobial resistance in patients with cirrhosis and hepatic encephalopathy using rifaximin.

ABSTRACT: Rifaximin, a non-absorbable antibiotic used in managing recurrent hepatic encephalopathy (HE), has traditionally been considered low risk for inducing resistance. However, emerging evidence raised concerns that widespread rifaximin use may promote antimicrobial resistance (AMR). In this multi-national retrospective cohort study, we evaluate the association between rifaximin use and subsequent AMR in patients with cirrhosis and HE. After propensity score matching for 78 covariates, hazard ratios (HRs) and 95% confidence intervals (CIs) for AMR and infection-related adverse events are calculated for the one-year follow-up. We demonstrate a two-fold AMR risk associated with rifaximin use (HR = 1.89; 95% CI = 1.49-2.40), with significantly increased risks of vancomycin resistance (HR = 2.52; 9

SUBMITTER: Kuo CH 

PROVIDER: S-EPMC12819376 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature