Turner et al 2024; Rifaximin prophylaxis causes resistance to the last-resort antibiotic daptomycin - Supplementary Table 10

This study found that daptomycin resistance is linked with the presence of specific rpoB mutations in vancomycin resistant Enterococcus faecium (VREfm), with resistance emerging de novo in E. faecium following exposure to rifaximin (RIFAX), a commonly prescribed antibiotic used prophylactically to prevent hepatic encephalopathy in liver disease patients. This work has uncovered a major mechanism of daptomycin resistance in VREfm and identified rifaximin, an antibiotic considered to be low-risk for the emergence of bacterial AMR, as an important driver of last-resort antibiotic resistance.