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)
This large systematic review found rectal NSAIDs significantly reduced the risk of post-ERCP pancreatitis compared to pancreatic duct stents (abstract).
This large population-based cohort found the most common causes of drug induced liver injury to be augmentin and diclofenac, followed by herbal and nutritional supplements (abstract).
This large trial of patients with a relative contraindication for enteral feeds were randomized to early TPN or usual care. There were no differences in the groups in 60 day mortality or LOS, but those on TPN did have a shorter time ventilated and less muscle/fat loss. It is unclear based on this trial if […]