Abstract

Dr. Sulma Bibi, Dr. Humaira Siddique* and Dr. Uzma Aziz

ABSTRACT

Aim: Comparison of Rifaximin with placebo for the treatment of hepatic encephalopathy Methods: A total of 150 cases (75 in Rifaximin and 75 in placebo group) presenting with liver cirrhosis and grade IV of hepatic encephalopathy in both gender and aging more than 20 years were enrolled in this study from Emergency/Outpatient Department of Medicine. Before randomization of patients in two groups (Rifaximin and Placebo), verbal consent of the participants was obtained for inclusion their data in this trial. We assured to keep their data confidential. After starting standard treatment to all the cases i.e. Lactulose 30ml 4 times a day, Bowel wash, oral Metronidazole 250mg TDS. Rifaximin group was advised for 550mg twice a day for one week while placebo group was advised 5% D/W1000cc. The patients were followed up to record the recurrence i.e. development of hepatic encephalopathy within 3 months of treatment. Results: In this study, out of 150 cases in Rifaximin Group, 30.67%(n=23) and 36%(n=27) were between 20-50 years of age while 69.33%(n=52) in Rifaximin and 64%(n=48) in Placebo Group were between 51-80 years of age, mean + SD was calculated as 54.42+9.21 years and 56.14+10.81 years respectively, 49.33% (n=37) in Rifaximin and 45.33%(n=34) in Placebo Group were males whereas 50.67%(n=38) in Rifaximin and 54.67% (n=41) in Placebo group were males. On comparison of both groups, we found recurrence rate as 28% in Rifaximin and 53.33% in Placebo group, p value was 0.002 showing a significant lower rate in Rifaximin group. Conclusion: The use of rifaximin shows significantly lower rate of recurrence of hepatic encephalopathy when compared to placebo.