Does low‐dose rifaximin ameliorate endotoxemia in patients with liver cirrhosis: a prospective study. Issue 11 (November 2015)

• Record Type: Journal Article
• Authors: Zeng, Xin; Tang, Xia Jiao; Sheng, Xia; Ni, Wu; Xin, Hai Guang; Chen, Wei Zhong; Jiang, Cai Feng; Lin, Yong; Shi, Jian; Shi, Bin; Chen, Yue Xiang; Yuan, Zong Li; Xie, Wei Fen
• Is Part Of: Journal of digestive diseases. Volume 16:Issue 11(2015:Nov.)
• Page Start: 665
• Page End: 674
• Publication Date: 2015-11
• Subjects: endotoxins -- liver cirrhosis -- rifaximin; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; 616.3
• DOI: 10.1111/1751-2980.12294
• Languages: English
• ISSNs: 1751-2972

Abstract

Abstract : Objective: To evaluate the efficacy, safety and tolerability of different doses of rifaximin in Chinese patients with liver cirrhosis. Methods: This random prospective study included a screening visit, a 2‐week treatment period and a subsequent 4‐week observation phase. Patients with liver cirrhosis were randomly assigned to a low‐dose rifaximin group, a high‐dose rifaximin group and the control group in a ratio of 1:1:1. The low‐dose and high‐dose groups received 400 mg or 600 mg rifaximin per 12 h for 2 weeks, respectively. All other therapeutic strategies remained unchanged in the three groups as long as possible. Results: In total, 60 patients with liver cirrhosis were screened and 43 of them met the eligibility criteria. After 2‐week treatment serum endotoxin levels in the low‐dose (1.1 ± 0.8 EU/mL) and high‐dose rifaximin groups (1.0 ± 0.8 EU/mL) were significantly lower than that in the control group (2.5 ± 1.8 EU/mL), while no significant difference was found between the two rifaximin‐treated groups. The effect of high‐dose rifaximin on endotoxemia lasted for at least 4 weeks after drug withdrawal. A significant reduction in the abundance of the Veillonellaceae taxa and an increase in the abundance of Bacteroidaceae were shown after 2 weeks of rifaximin therapy. The incidence of adverse events and severe adverse events was similar among the three groups. Conclusion: Low‐dose (800 mg/day) rifaximin could be analogous to high‐dose (1200 mg/day) rifaximin to reduce the serum endotoxin level after 2 weeks of treatment.