Rifaximin for preventing hepatic encephalopathy

By  |  April 1, 2010 | 

In this trial of 299 patients with chronic liver disease and recurrent hepatic encephalopathy (in remission), they were randomized to rifaximin (550mg BID) or placebo for 6 months (>90% also received concomitant lactulose). The rifaximin group had significantly reduced risk of recurrence of hepatic encephalopathy (Hazard Ratio 0.42, CI 0.28-0.64), occurring in 22% of the rifaximin group and 46% of the placebo group. Risk of hospitalization associated with encephalopathy was also significantly less in the rifaximin group (14% vs 23%). Adverse events were similar between the groups. The risk of recurrent encephalopathy and hospitalizations can be reduced with rifaximin (abstract), however, cost is an issue, as 600mg BID would cost > $1,000/month (drugstore.com)

About the Author:

Danielle Scheurer
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.


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