Current Status of Rifaximin Treatment for Hepatic Encephalopathy at Our Hospital

Abstract

【Background】Causes of hepatic encephalopathy are mainly due to decreased metabolic capacity associated with hepatic parenchymal dysfunction and portosystemic shunt associated with portal hypertension. The basis of treatment is the removal of toxic substances, mainly ammonia, and the correction of metabolism of amino acids. In recent years, rifaximin, poorly absorbed antibiotics became available. This time, we decided to investigate the use of rifaximin and its therapeutic effects.

【Methods】The subjects were 60 cirrhosis patients who received rifaximin for hepatic encephalopathy in our hospital from September 2016 to November 2019. We investigated the efficacy and safety of patients with hepatic encephalopathy.

【Results】Concomitant drugs were branched chain amino acid preparation（88%），lactulose（75%），levocarnitine preparation（42%），and zinc preparation（6.7%）．Good results were also obtained in patients switching from kanamycin sulfate. Serum ammonia concentration was approximately halved one month after rifaximin administration, and good control was obtained thereafter. Relapse of hepatic encephalopathy was concentrated within 100 days from the start of rifaximin administration. Overt encephalopathy relapse was more common in the elderly, patients with high Child-Pugh scores, and patients with portosystemic shunt.

【Conclusion】The current state of rifaximin administration in our department, the efficacy and safety for hepatic encephalopathy were confirmed.