Rifaximin did not improve 12-month survival or reduce liver complications in patients with severe cirrhosis and low-protein ascites when used as primary prophylaxis for spontaneous bacterial peritonitis (SBP).
Adherence to rifaximin was associated with reduced liver-related complications, suggesting the importance of treatment compliance.
No significant safety concerns were found with rifaximin over 12 months.
This trial challenges the routine use of rifaximin for primary SBP prophylaxis in this patient population, emphasizing the need for further research and adherence monitoring.
