Rifaximin for the Treatment of Hepatic Encephalopathy

Lawrence, Kenneth; Klee, Jacqueline A.

doi:10.1592/phco.28.8.1019

Cited by 79 publications

(58 citation statements)

References 23 publications

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“…3,4 Mantiene la remisión, previene la aparición de nuevos episodios y mejora los resultados de laboratorio y el estado mental de estos pacientes. 3,5,6 Luego de varias comunicaciones sobre su uso, la rifaximina fue aprobada por la FDA para el tratamiento de la diarrea del viajero en niños mayores de 12 años de edad. 8,9,11 Es una opción de tratamiento ampliamente utilizada para la enfermedad inflamatoria intestinal, por su amplio espectro de actividad y su bajo perfil de efectos adversos.…”

Section: Discussionunclassified

“…2 Recientemente, la rifaximina fue aprobada para el tratamiento de la encefalopatía hepáti-ca en pacientes adultos. [3][4][5][6][7][8] 12 Se trata de un derivado prácticamente no absorbible de la rifamicina que actúa inhibiendo la síntesis del ácido ribonucleico y posee un amplio espectro de actividad contra especies grampositivas y gramnegativas de la flora intestinal. 7 Comunicamos el caso de una paciente cirróti-ca en edad pediátrica, con encefalopatía hepática, que mostró mejoría clínica luego del tratamiento con rifaximina.…”

Section: Introduccionunclassified

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Rifaximina para encefalopatía hepática en niños. Caso clínico

et al. 2011

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Presentación de casos clínicos RESUMENLa rifaximina es un antibiótico recientemente aprobado para el tratamiento de la encefalopatía hepática en adultos. En niños mayores de 12 años se aprobó su uso en la diarrea del viajero y se lo emplea ampliamente en la enfermedad inflamatoria intestinal. Comunicamos el primer caso del que tenemos conocimiento, de un paciente en edad pediátrica que recibió rifaximina para tratar la encefalopatía hepática, con buena respuesta clínica. Palabras clave: rifaximina, encefalopatía hepática, pediatría. SUMMARYRifaximin is an antibiotic recently approved for the treatment of hepatic encephalopathy in adults. In children more than 12 year-old, it has been approved for travelers' diarrhea and it is also widely used in inflammatory bowel disease. We report, to our knowledge, the first case of a pediatric patient who received rifaximin for hepatic encephalopathy with good clinical outcome.

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Section: Discussionunclassified

Section: Introduccionunclassified

Rifaximina para encefalopatía hepática en niños. Caso clínico

et al. 2011

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“…Hence, in patients with HE, rifaximin is as good or better than other antibiotics and non-absorbable disaccharides, and achieves early clinical improvement with better tolerance by the patient [27]. Further, rifaximin has been found to be superior to placebo as secondary prophylaxis.…”

Section: Antibioticsmentioning

confidence: 99%

Pharmacotherapy of hepatic encephalopathy in cirrhosis

Romero‐Gómez

2010

Expert Opinion on Pharmacotherapy

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“…Rifaximina viene scarsamente assorbita e si concentra elettivamente nel tratto GI e comporta un basso rischio di sviluppare resistenze, il che la rende adatta all'utilizzo a lungo termine [91][92][93]. Ne è stata ampiamente dimostrata l' efficacia, la quale è pari o superiore a quella dei disaccaridi non assorbibili e degli altri antibiotici [94,95]. Inoltre, è stato dimostrato come rifaximina sia in grado di migliorare la qualità di vita e le capacità di guida dei pazienti con EE minima [96,97].…”

Section: Antibiotici Non Assorbibiliunclassified

A look at the hepatic encephalopathy in cirrhosis

Zaccherini

Tufoni

Ricci

et al. 2013

RHC

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Hepatic encephalopathy (HE) is a neuropsychiatric syndrome complicating acute and chronic liver failure and characterized by a wide range of manifestations, in absence of other brain disease. HE is very frequent in course of cirrhosis and even mild forms involve a great additional burden on patients, their families and health-care resources. Its onset affects subsequent survival of patients. Historically, pathophysiology of HE was connected to several substances (mostly ammonia) produced in the gut and normally metabolized by the liver, but more recently other factors such as inflammation, bacterial translocation and oxidative stress have shown a crucial role. Symptoms are often overt (confusion, asterixis, disorientation, ataxia or coma) but can also be subtle (sleep disturbances, cognitive impairment, mood alterations, impairment of executive decision-making, and psychomotor speed – Minimal HE); the West Haven Criteria are most often used to grade Overt HE (OHE), with grade ranging from 0 to 4 (4 corresponding to coma). Since both Minimal HE and grade 1 HE cannot be diagnosed by clinical examination and need for specific tests, it results practical to combine these entities and name them "Covert" HE (CHE) to aid clinical use. Diagnosis is based on evidence of neurological impairment in presence of liver cirrhosis, only after the exclusion of other brain diseases. Measurement of serum ammonia and electroencephalography are little specific, while brain magnetic resonance and search for portosystemic shunts are important in complex cases. Diagnosis of OHE is often just clinical, while that of CHE requires dedicated psychometric and neurophysiological tests. Although these tests are difficult to be performed in the clinical practice, detection and treatment of CHE are cost-effective and important; indeed, CHE affects patients’ quality of life, socioeconomic status and driving skills, and increases the risk for falls, car accidents, development of OHE, and death. Management of HE includes early diagnosis and prompt treatment of precipitating factors (infection, gastrointestinal bleeding, electrolyte disturbances, dehydration, hypotension, use of benzodiazepines, psychoactive drugs, and/or alcohol). Current treatment is based principally on reducing intestinal ammonia with nonabsorbable disaccharides (lactulose or lactitol); rifaximin, used solely or in addition, is also becoming a first-line treatment.

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Rifaximin for the Treatment of Hepatic Encephalopathy

Cited by 79 publications

References 23 publications

Rifaximina para encefalopatía hepática en niños. Caso clínico

Rifaximina para encefalopatía hepática en niños. Caso clínico

Pharmacotherapy of hepatic encephalopathy in cirrhosis

A look at the hepatic encephalopathy in cirrhosis

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