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Having shown that short\u2010term administration of rifaximin improves liver hemodynamics in decompensated cirrhosis, we conducted this study to investigate the effect of intestinal decontamination with rifaximin on the long\u2010term prognosis of patients with alcohol\u2010related decompensated cirrhosis (<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>hild\u2010<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>ugh &gt;\u20097) and ascites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who had received rifaximin and showed improved liver hemodynamics were enrolled in the current study and continued to receive rifaximin (1200\u2009mg\/day). Each patient was matched by age, sex, and <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>hild\u2010<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>ugh grade to two controls and followed up for up to 5 years, death or liver transplantation. Survival and risk of developing portal hypertension\u2010related complications were compared between rifaximin group and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty three patients fulfilled the inclusion criteria and matched with 46 controls. Patients who received rifaximin had a significant lower risk of developing variceal bleeding (35% <jats:italic>vs<\/jats:italic> 59.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.011), hepatic encephalopathy (31.5% <jats:italic>vs<\/jats:italic> 47%, <jats:italic>P<\/jats:italic>\u2009=\u20090.034), spontaneous bacterial peritonitis (4.5% <jats:italic>vs<\/jats:italic> 46%, <jats:italic>P<\/jats:italic>\u2009=\u20090.027), and hepatorenal syndrome (4.5% <jats:italic>vs<\/jats:italic> 51%, <jats:italic>P<\/jats:italic>\u2009=\u20090.037) than controls. Five\u2010year cumulative probability of survival was significantly higher in patients receiving rifaximin than in controls (61% <jats:italic>vs<\/jats:italic> 13.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.012). In the multivariate analysis, rifaximin administration was independently associated with lower risk of developing variceal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome, and higher survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with alcohol\u2010related decompensated cirrhosis, long\u2010term rifaximin administration is associated with reduced risk of developing complications of portal hypertension and improved survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.12070","type":"journal-article","created":{"date-parts":[[2012,12,6]],"date-time":"2012-12-06T13:40:15Z","timestamp":1354801215000},"page":"450-455","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":184,"title":["Long\u2010term administration of rifaximin improves the prognosis of patients with decompensated alcoholic cirrhosis"],"prefix":"10.1111","volume":"28","author":[{"given":"Jiannis","family":"Vlachogiannakos","sequence":"first","affiliation":[{"name":"Hepatogastroenterology Unit 1st Department of Medicine\u2014Propaedeutic Medical School, Athens University, Laiko General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikos","family":"Viazis","sequence":"additional","affiliation":[{"name":"Second Department of Gastroenterology Evangelismos Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Vasianopoulou","sequence":"additional","affiliation":[{"name":"Second Department of Gastroenterology Evangelismos Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Vafiadis","sequence":"additional","affiliation":[{"name":"Hepatogastroenterology Unit 1st Department of Medicine\u2014Propaedeutic Medical School, Athens University, Laiko General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios G","family":"Karamanolis","sequence":"additional","affiliation":[{"name":"Second Department of Gastroenterology Evangelismos Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spiros D","family":"Ladas","sequence":"additional","affiliation":[{"name":"Hepatogastroenterology Unit 1st Department of Medicine\u2014Propaedeutic Medical School, Athens University, Laiko General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,2,26]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.03.007"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90147-7"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20632"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8278(95)80424-2"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)06020-6"},{"key":"e_1_2_5_7_1","first-page":"G605","article-title":"Endothelin\u20101 production by hepatic endothelial cells: characterization and augmentation by endotoxin exposure","volume":"272","author":"Eakes AT","year":"1997","journal-title":"Am. 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