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Comparison of once a day rifaximin to twice a day dosage in the prevention of recurrence of hepatic encephalopathy in patients with chronic liver disease
Author(s) -
Khokhar Nasir,
Qureshi Muhammad Omar,
Ahmad Shafiq,
Ahmad Aiza,
Khan Hamza Hassan,
Shafqat Farzana,
Salih Muhammad
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12970
Subject(s) - rifaximin , medicine , hepatic encephalopathy , cirrhosis , gastroenterology , encephalopathy , liver disease , randomized controlled trial , chronic liver disease , antibiotics , microbiology and biotechnology , biology
Background Rifaximin has been used for prevention of recurrence of hepatic encephalopathy in twice a day dosage. The drug is expensive and lower dising may be possible. Objective To determine the efficacy of rifaximin once a day dose in the prevention of hepatic encephalopathy ( HE ) in patients with liver cirrhosis as compared with twice daily dose of rifaximin. Methods This R andomized control trial was carried out at the D epartment of G astroenterology and H epatology, S hifa I nternational H ospital, I slamabad, P akistan from N ovember 2012 to F ebruary 2014. Patients with known chronic liver disease with at least one episode of HE in the past were randomized to group A (rifaximin 550 mg OD ) and group B (rifaximin 550 mg BD ), after fulfilling the inclusion criteria. Each patient was followed for 6 months for any episode of HE . Patients in each group were identified for any breakthrough episode of encephalopathy during this period. Data were analyzed using SPSS version 16. Chi‐squared test and t ‐test were applied where required to determine the significant difference between the two groups. Results There were a total of 306 patients: 128 patients in Group A while 178 in group B. Majority of patients (75.81%) had hepatitis C virus with mean age of 52.30 ± 9.92, MELD score 13.58 ± 8.3, and 55.22% were in Child–Pugh B. Eighty‐one patients had an episode of HE during the study period. There were 27 patients in group A and 54 patients in group B with breakthrough episode of HE ( P = 0.088). Conclusion This study suggests that there is no significant difference in rifaximin once a day or twice daily dose in preventing HE .