RIFAXIMIN IN THE TREATMENT OF CHRONIC HEPATIC-ENCEPHALOPATHY

A study was performed to assess the efficacy and tolerability of rifax imin in the treatment of encephalopathy during cirrhosis of the liver. Fifty-five patients suffering from grade 1, 2 and 3 portosystemic enc ephalopathy, with a mean age of 58.9 years (range 30 to 86 years) were evaluated. The patients were treated for 15 consecutive days with rif aximin, an antibiotic which is not absorbed by the intestinal wall, at a dosage of 1200 mg/day in association with sufficient lactulose to i nduce 2 or 3 evacuations per day. Combined use of the 2 drugs proved a n efficient means of controlling the majority of signs and symptoms. A fter just a few days, an improvement in the signs of encephalopathy wa s noted in all patients. The treatment was well tolerated and the pati ents completed the trial without any drug-related side-effects. The re sults of our trial, although in the context of an open assessment, con firm the clinical efficacy of rifaximin in association with a non-adso rbable disaccharide such as lactulose. The 2 compounds have a synerget ic effect in reducing ammonia-producing flora. Its efficacy and good t olerability make rifaximin a valid alternative to the use of aminoglyc oside antibiotics associated with disaccharides in the treatment of pa tients with liver disease, particularly in the case of prolonged thera py.