ANTIBACTERIAL ACTIVITY OF RIFAXIMIN REDUCES THE LEVELS OF BENZODIAZEPINE-LIKE COMPOUNDS IN PATIENTS WITH LIVER-CIRRHOSIS

Benzodiazepine-like compounds are present in trace amounts in the bloo d of normal subjects and increase in liver cirrhotic patients with or without encephalopathy. Their increased presence may, however, represe nt an occasional precipitating factor of hepatic encephalopathy. The s ource of these compounds is still unknown, but they are constituents o f our diet since benzodiazepine receptor ligands have been described i n plants, vegetables and in animals. They may also be synthesized, at least in part, by intestinal bacterial flora. In this article we repor t that the level of these compounds in the blood decreased by 40% afte r therapy with rifaximin, which reduces the aerobic and anaerobic inte stinal bacterial flora. This observation indicates that intestinal bac terial flora is involved in the production of these compounds and that repeated short-term medications with this non-absorbable antibiotic m ay be useful in reducing the levels of benzodiazepine-like compounds i n patients with liver cirrhosis. (C) 1997 The Italian Pharmacological Society.