Primary Prophylaxis of Hepatic Encephalopathy in Decompensated Cirrhosis: Low Dose Vs. Full Dose Rifaximin

Overview

Journal Pak J Med Sci

Specialty General Medicine

Date 2019 Sep 7

PMID 31489023

Citations 5

Authors

Shahid Sarwar

Bushra Muhyuddin

Abdul Aleem

Muhammad Arif Nadeem

Affiliations

Soon will be listed here.

Abstract

Objective: To compare efficacy of high vs low dose rifaximin for primary prophylaxis of portosystemic encephalopathy (PSE) in decompensated liver cirrhosis.

Methods: In a quasi-experimental double blind randomized study at Services Institute of Medical Sciences (SIMS), Lahore from August 2017 to August 2018, patients of decompensated cirrhosis with no previous PSE were randomized to receive twice daily rifaximin 200mg in Group-A and 550mg in Group-B. Patients were followed for 6 months for development of PSE.

Results: In 75 included patients, mean age was 53.8(±10.7) years and male/female ratio was 0.97/1(37/38). After randomization, 34 (45.3%) patients were included in Group-A and 41 (54.7%) patients in Group-B. During 6 month follow up 24 (32%) patients developed PSE, 12 (35.2%) in Group-A and 12 (29.2%) in Group-B, difference was not significant (p value 0.57). In 6 months, 13 (17.3%) patient died, 6 (17.6%) in Group-A and 7 (17.07%) patients in Group-B, difference not significant (p value 0.94). Patients who died had higher bilirubin (p < 0.00), higher serum creatinine (p 0.05), high CTP score (p 0.04) and worse MELD score (p 0.004).

Conclusion: Rifaximin is not effective for primary prophylaxis of overt hepatic encephalopathy in decompensated cirrhosis patients.

Citing Articles

Preventive and therapeutic effects of rifaximin on hepatic encephalopathy with differential application dosages and strategies: a network meta-analysis.

Fang G, Liu S, Liu B BMC Gastroenterol. 2024; 24(1):94.

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Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.

Zacharias H, Kamel F, Tan J, Kimer N, Gluud L, Morgan M Cochrane Database Syst Rev. 2023; 7:CD011585.

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Bears, beets, rifaximin.

Wang P, Flemming J Can Liver J. 2022; 4(4):438-442.

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Efficacy and Safety of Rifaximin Versus Placebo or Other Active Drugs in Critical ill Patients With Hepatic Encephalopathy.

Han X, Luo Z, Wang W, Zheng P, Li T, Mei Z Front Pharmacol. 2021; 12:696065.

PMID: 34690751 PMC: 8533823. DOI: 10.3389/fphar.2021.696065.

Evaluation of the Long-term Administration of Rifaximin for More than Three Years in the Treatment of Repeated and Recurrent Overt Hepatic Encephalopathy.

Fujiwara Y, Suzuki K, Yusa K, Eizuka M, Miura M, Watanabe Y Intern Med. 2021; 60(7):1027-1033.

PMID: 33790139 PMC: 8079929. DOI: 10.2169/internalmedicine.5793-20.

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