Is Lactulose Plus Rifaximin Better Than Lactulose Alone In The Management Of Hepatic Encephalopathy?

• Published in: Journal of the College of Physicians and Surgeons--Pakistan Vol. 28; no. 2; pp. 115 - 117
• Main Authors: Ismat Butt, Nauman, Ismat Butt, Usman, Anser Tufail Khan Kakar, Aniqa, Malik, Tashia, Mahmood Siddiqui, Arif
• Format: Journal Article
• Language: English
• Published: Pakistan College of Physicians and Surgeons Pakistan 01.02.2018
• Subjects: Adult; Aged; Drug Administration Schedule; Drug therapy; Drug Therapy, Combination; Female; Gastrointestinal Agents - administration & dosage; Gastrointestinal Agents - therapeutic use; Hepatic Encephalopathy - drug therapy; Humans; Lactulose; Lactulose - administration & dosage; Lactulose - therapeutic use; Liver encephalopathy; Liver Failure - drug therapy; Male; Middle Aged; Rifamycins - administration & dosage; Rifamycins - therapeutic use; Rifaximin; Testing; Treatment Outcome
• ISSN: 1022-386X; 1681-7168; 1681-7168
• DOI: 10.29271/jcpsp.2018.02.115

To compare the efficacy of lactulose plus rifaximin with efficacy of lactulose alone in the treatment of hepatic encephalopathy. A randomized controlled trial. Department of Medicine, Jinnah Hospital, Lahore, from December 2014 to June 2015. All patients who presented with hepatic encephalopathy due to decompensated chronic liver disease were randomly divided into two groups of 65 patients each. One group was given 30 ml thrice daily lactulose alone and the other lactulose plus rifaximin 550 mg twice daily for 10 days. Informed consents were taken from the participants' attendants. Grades II-IV hepatic encephalopathy was noted according to West-Haven Classification. All subjects were followed until 10 days after admission. The mean age of patients was 56.06 +11.2 years, among which 46.9% were females and 53.1% were males. After ten days of follow-up, reversal was seen in 58.46% in lactulose alone group and 67.69% in lactulose plus rifaximin group (Chi-square p=0.276). There was no difference in effectiveness of lactulose plus rifaximin and lactulose alone in treatment of hepatic encephalopathy.