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Grant support

Supported by a H2020 Grant - LIVERHOPE -project number: 731875. The work described has been funded by a H2020 Grant - LIVERHOPE - project number: 731875. P.G. has been funded by grant numbers PI16/00043 and PI20/00529, and E.S. is funded by PI18/00727, both of which are integrated in the Plan Nacional I+ D+I and cofunded by ISCIII-Subdireccion General de Evaluacion and European Regional Development Fund FEDER. E.P., E.S., P.G., and other members of the LIVERHOPE Consortium have been funded by a grant from AGAUR 2017SGR-01281.

Analysis of institutional authors

Pich Martinez, JuditAuthorFabrellas Padrés, NúriaAuthorSola EAuthorPose EAuthorGines PCorresponding Author
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Review

The use of Rifaximin in Patients with Cirrhosis

Publicated to:Hepatology. 74 (3): 1660-1673 - 2021-09-01 74(3), DOI: 10.1002/hep.31708

Authors: Caraceni, P; Vargas, V; Solà, E; Pose, E; Ginès, P; Alessandria, C; de Wit, K; Beuers, U; Trebicka, J; Angeli, P; Mookerjee, RP; Durand, F; Krag, A; Bajaj, JS

Affiliations

Amsterdam University Medical Centers, location AMC, Amsterdam, Netherlands. - Author
Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark. - Author
Division of Gastroenterology and Hepatology, Città della Salute e della Scienza Hospital, University of Torino, Italy. - Author
EF-CLIF, Barcelona, Catalonia, Spain. - Author
Goethe-University - Frankfurt am Main, Frankfurt am Main, Germany. - Author
Hospital Beaujon, Clichy, APHP, France. - Author
Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBEReHD, Barcelona, Catalonia, Spain. - Author
Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, CIEREHD, Barcelona, Catalonia, Spain. - Author
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. - Author
Royal Free Hospital, University College London, United Kingdom. - Author
University Hospital of Padova, Padova, Italy. - Author
University of Bologna, University hospital S. Orsola-Malpighi di Bologna, Italy. - Author
VirginiaCommonwealth University Medical Center, Richmond, Virginia, USA. - Author
‎ EF CLIF, Barcelona, Catalonia, Spain - Author
‎ Goethe Univ Frankfurt Main, Frankfurt, Germany - Author
‎ Hosp Beaujon, AP HP, Paris, France - Author
‎ Odense Univ Hosp, Dept Gastroenterol & Hepatol, Odense, Denmark - Author
‎ UCL, Royal Free Hosp, London, England - Author
‎ Univ Amsterdam, Med Ctr, Amsterdam, Netherlands - Author
‎ Univ Autonoma Barcelona, Hosp Vall dHebron, CIEREHD, Barcelona, Catalonia, Spain - Author
‎ Univ Barcelona, Hosp Clin Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain - Author
‎ Univ Bologna, Univ Hosp S Orsola Malpighi Bologna, Bologna, Italy - Author
‎ Univ Hosp Padova, Padua, Italy - Author
‎ Univ Southern Denmark, Inst Clin Res, Odense, Denmark - Author
‎ Univ Torino, Citta Salute & Sci Hosp, Div Gastroenterol & Hepatol, Turin, Italy - Author
‎ Virginia Commonwealth Univ, Med Ctr, Richmond, VA USA - Author
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Abstract

Rifaximin is an oral non-systemic antibiotic, with minimal gastrointestinal absorption and broad-spectrum antibacterial activity covering both grampositive and gramnegative organisms. Rifaximin is currently worldwide used in patients with cirrhosis for preventing recurrent hepatic encephalopathy because its efficacy and safety has been proved by large randomized clinical trials. In the last decade, experimental and clinical evidence suggest that rifaximin could have other beneficial effects on the course of cirrhosis by modulating the gut microbiome and affecting the gut-liver axis, which, in turn, can interfere with major events of the pathophysiological cascade underlying decompensated cirrhosis, such as systemic inflammatory syndrome, portal hypertension, and bacterial infections. However, the use of rifaximin for prevention or treatment of other complications, including spontaneous bacterial peritonitis or other bacterial infections, is not accepted as evidence by clinical trials is still very weak. The present review deals in the first part with the potential impact of rifaximin on pathogenic mechanisms in liver diseases, whereas, in the second part, its clinical effects are critically discussed. It clearly emerges that, due to its potential activity on multiple pathogenic events, the efficacy of rifaximin in the prevention or management of complications other than hepatic encephalopathy deserves to be investigated extensively. The results of double-blinded, adequately powered randomized clinical trials assessing the effect of rifaximin, alone or in combination with other drugs, on hard clinical endpoints, such as decompensation of cirrhosis, acute-on-chronic liver failure and mortality, are therefore eagerly awaited.This article is protected by copyright. All rights reserved.

Keywords
controlled-trialcost-effectivenessdouble-blindgut microbiotahepatic-encephalopathyhepatorenal-syndromeintestinal floraprimary prophylaxisrefractory ascitesBacterial translocationChronic liver diseasesControlled-trialCost-effectivenessDouble-blindGut microbiotaGut-liver axisHepatic-encephalopathyHepatorenal-syndromeIntestinal floraLiver fibrosisPortal hypertensionPrimary prophylaxisRefractory ascitesSpontaneous bacterial peritonitis

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Hepatology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2021, it was in position 6/93, thus managing to position itself as a Q1 (Primer Cuartil), in the category Gastroenterology & Hepatology. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 4.87. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 4.87 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 38.63 (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-13, the following number of citations:

  • WoS: 75
  • Scopus: 95
  • Europe PMC: 37
Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-05-13:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 95.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 95 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 35.95.
  • The number of mentions on the social network X (formerly Twitter): 43 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Denmark; France; Germany; Italy; Netherlands; United Kingdom; United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (Ginès Gibert, Pere).

the author responsible for correspondence tasks has been Ginès Gibert, Pere.