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. 2019 Sep-Oct;35(5):1446-1450.
doi: 10.12669/pjms.35.5.549.

Primary prophylaxis of hepatic encephalopathy in decompensated cirrhosis: Low dose vs. full dose rifaximin

Shahid Sarwar  1 , Bushra Muhyuddin  2 , Abdul Aleem  3 , Muhammad Arif Nadeem  4
Affiliations

Primary prophylaxis of hepatic encephalopathy in decompensated cirrhosis: Low dose vs. full dose rifaximin

Shahid Sarwar et al. Pak J Med Sci. 2019 Sep-Oct.

Abstract

Objective: To compare efficacy of high vs low dose rifaximin for primary prophylaxis of portosystemic encephalopathy (PSE) in decompensated liver cirrhosis.

Methods: In a quasi-experimental double blind randomized study at Services Institute of Medical Sciences (SIMS), Lahore from August 2017 to August 2018, patients of decompensated cirrhosis with no previous PSE were randomized to receive twice daily rifaximin 200mg in Group-A and 550mg in Group-B. Patients were followed for 6 months for development of PSE.

Results: In 75 included patients, mean age was 53.8(±10.7) years and male/female ratio was 0.97/1(37/38). After randomization, 34 (45.3%) patients were included in Group-A and 41 (54.7%) patients in Group-B. During 6 month follow up 24 (32%) patients developed PSE, 12 (35.2%) in Group-A and 12 (29.2%) in Group-B, difference was not significant (p value 0.57). In 6 months, 13 (17.3%) patient died, 6 (17.6%) in Group-A and 7 (17.07%) patients in Group-B, difference not significant (p value 0.94). Patients who died had higher bilirubin (p < 0.00), higher serum creatinine (p 0.05), high CTP score (p 0.04) and worse MELD score (p 0.004).

Conclusion: Rifaximin is not effective for primary prophylaxis of overt hepatic encephalopathy in decompensated cirrhosis patients.

Keywords: Decompensated cirrhosis; Portosystemic encephalopathy; Primary prophylaxis; Rifaximin.

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Conflict of interest statement

Conflict of interest: None to declare.

Figures

Fig.1
Fig.1
Kaplan Mayer Survival curve comparing Group-A and B.
See this image and copyright information in PMC

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