Editorial: rifaximin and minimal hepatic encephalopathy.
Author(s): Butterworth RF.
Affiliation(s): Comment on
Am J Gastroenterol. 2011 Feb;106(2):307-16.
Publication date & source: 2011, Am J Gastroenterol. , 106(2):317-8
Minimal hepatic encephalopathy (MHE) occurs in up to 70% of patients with
cirrhosis and has a clear impact on health-related quality of life (HRQOL) in
these patients. Antibiotics leading to reductions in circulating ammonia have
been used in the past for the treatment of MHE. However, serious adverse effects
such as nephrotoxicity, ototoxicity, and peripheral neuropathy limit their use to
relatively short time periods. In this issue of the American Journal of
Gastroenterology, an article by Sidhu et al. demonstrates unequivocally that the
antibiotic rifaximin, a minimally absorbed antibiotic with broad spectrum
activity, improves psychometric test performance scores and concomitantly
improves HRQOL in patients with MHE (the RIME Trial). Rifaximin was well
tolerated. Results of the RIME Trial represent an important step in the
establishment of this antibiotic as an effective and safe treatment for MHE.
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