TREATMENT OF ACUTE HEPATIC-ENCEPHALOPATHY BY LACTULOSE-NEOMYCIN COMBINATION VERSUS PLACEBO - A RANDOMIZED CONTROLLED ASSAY

Objectives. - The effectiveness of the association of lactulose with n eomycin in the treatment of acute hepatic encephalopathy has never bee n assessed. The aim of this study was to compare the effects of lactul ose-neomycin combination versus placebo in acute hepatic encephalopath y. Methods. - Eighty patients with cirrhosis were randomly treated for 5 days with placebo (n = 40) or with lactuloseneomycin (n = 40). Both groups were similar for all variables. Results. - The course of encep halopathy was similar in both groups. In the lactulose-neomycin group: 26 patients recovered, 3 remained unchanged, 3 worsened, 6 died, 2 we re-lost to follow-up. In the placebo groupl 28 recovered, 2 remained u nchanged 2 worsened, 6 died, one was lost the follow-up, one dropped o ut of the study. Lactulose-neomycin treatment was not well tolerated i n a significant number of patients. Conclusion. - Lactulose-neomycin c ombination should not be used in the treatment of acute hepatic enceph alopathy.