Rifaximin may be associated with reduced length in hospital stay among patients with severe acute pancreatitis, Shivam Kalia, MD, said during his oral paper presentation at the 2023 ACG Annual Scientific Meeting on October 25, in Vancouver, Canada. However, no such association was found between the use of rifaximin and reduced mortality among these patients.

Dr Kalia is a professor of medicine in the department of gastroenterology and hepatology at the Kalinga Institute of Medical Sciences in Bhubaneshwar, India.

This presentation was awarded the ACG Governors Award for Excellence in Clinical Research.

“Our randomized pilot study, although suggesting a trend toward reducing mortality, did not show any significant superiority of rifaximin on mortality of prevention of infection in patients with predicted severe acute pancreatitis,” Dr Kalia said. “However, the length of hospital stay was significantly shorter in the rifaximin group.”

The randomized control trial had 50 patients in group A (patients receiving rifaximin 550 mg twice daily for 14 days plus standard treatment) and 50 patients in group B (no rifaximin, only standard treatment). Primary endpoints included development of pancreatic necrosis and mortality. Secondary endpoints were length of hospital or ICU stay and development of organ failure.

The results were as follows:

• Median duration of hospitalization: 8 days in group A vs 11.5 days in group B (p value = 0.002)
• Median duration of ICU stay: 3 days in group A vs 5 days in group B ( p value= 0.209)
• Development of organ failure: 56% in group A vs 60% in group B (p value= 0.525)
• Patients with infected pancreatic necrosum: 31 in group A vs 35 in group B (p = 0.507)
• Rate of mortality: 9 in group A vs 14 in group B (p value= 0.603)

“We still need to conduct further trials with a larger sample size to validate the benefits of gut decontamination with rifaximin in patients with severe acute pancreatitis,” Dr Kalia concluded.

Reference:
Kalia S. 60 - Impact of Gut Decontamination by Rifaximin in Patients With Predicted Severe Acute Pancreatitis : A Pilot Study. Plenary Session 4A - Biliary / Pancreas / Interventional Endoscopy. Presented at: 2023 ACG Postgraduate Course. Vancouver, Canada. October 25, 2023.