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Does low‐dose rifaximin ameliorate endotoxemia in patients with liver cirrhosis: a prospective study
Author(s) -
Zeng Xin,
Tang Xia Jiao,
Sheng Xia,
Ni Wu,
Xin Hai Guang,
Chen Wei Zhong,
Jiang Cai Feng,
Lin Yong,
Shi Jian,
Shi Bin,
Chen Yue Xiang,
Yuan Zong Li,
Xie Wei Fen
Publication year - 2015
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12294
Subject(s) - rifaximin , medicine , cirrhosis , tolerability , gastroenterology , adverse effect , prospective cohort study , incidence (geometry) , antibiotics , physics , optics , microbiology and biotechnology , biology
Objective To evaluate the efficacy, safety and tolerability of different doses of rifaximin in Chinese patients with liver cirrhosis. Methods This random prospective study included a screening visit, a 2‐week treatment period and a subsequent 4‐week observation phase. Patients with liver cirrhosis were randomly assigned to a low‐dose rifaximin group, a high‐dose rifaximin group and the control group in a ratio of 1:1:1. The low‐dose and high‐dose groups received 400 mg or 600 mg rifaximin per 12 h for 2 weeks, respectively. All other therapeutic strategies remained unchanged in the three groups as long as possible. Results In total, 60 patients with liver cirrhosis were screened and 43 of them met the eligibility criteria. After 2‐week treatment serum endotoxin levels in the low‐dose (1.1 ± 0.8 EU/mL) and high‐dose rifaximin groups (1.0 ± 0.8 EU/mL) were significantly lower than that in the control group (2.5 ± 1.8 EU/mL), while no significant difference was found between the two rifaximin‐treated groups. The effect of high‐dose rifaximin on endotoxemia lasted for at least 4 weeks after drug withdrawal. A significant reduction in the abundance of the Veillonellaceae taxa and an increase in the abundance of Bacteroidaceae were shown after 2 weeks of rifaximin therapy. The incidence of adverse events and severe adverse events was similar among the three groups. Conclusion Low‐dose (800 mg/day) rifaximin could be analogous to high‐dose (1200 mg/day) rifaximin to reduce the serum endotoxin level after 2 weeks of treatment.