ABSTRACT

Objective: To differentiate the effectiveness of rifaximin in protosystemic primary prophylaxis of hepatic encephalopathy patients by using high and low dose.

Study Design: Randomized controlled trial

Place and Duration of Study:Department of Medicine, Avicenna Medical & Dental College Lahore from 1st October 2019 to 31st March 2020

Methodology: Eighty patients of both genders with liver cirrhosis diagnosed to have hepatic encephalopathy were enrolled. Patient’s detailed demographics including age, gender, BMI and etiology of liver cirrhosis were recorded after taking written consent. Patients were equally divided into two groups, each group contains 40 patients, Group 1 received 200 mg dose of rifaximin twice a daily and group 2 received 550 mg of rifaximin twice a daily. Patients were followed for 6 months. Effectiveness in term of protosystemic hepatic encephalopathy and mortality were examined at the end of treatment.

Results:There were 22 (55%) males and 18 (45%) female patients in group 1 and in group 2, 20 (50%) patients was male and 20 (50%) were females. No significant difference was observed regarding mean age of patients between both groups 1 and 2 (48.76±11.38 years Vs 49.02±10.44 years). In group 1 PSE developed in 16 (40%) patients and in group 2 it was developed in 14 (35%) patients, no significant difference was found between both groups with p-value >0.05. During follow-up overall 17 patients were died, 9 (22.5%) in group 1 and 8 (20%) in group 2. There were no any significant difference found between died patients (p value 0.97).

Conclusion:The use of rifaximin either low or high dose is not effective to prevent development of protosystemic hepatic encephalopathy.

Keywords: Efficacy, Rifaximin, Prophylaxis, Prostosystemic encephalopathy