title: Comparison of once a day rifaximin to twice a day dosage in the prevention of recurrence of hepatic encephalopathy in patients with chronic liver disease.
abstract: BACKGROUND
  Rifaximin has been used for prevention of recurrence of hepatic encephalopathy in twice a day dosage. The drug is expensive and lower dising may be possible.
  
  
  OBJECTIVE
  To determine the efficacy of rifaximin once a day dose in the prevention of hepatic encephalopathy (HE) in patients with liver cirrhosis as compared with twice daily dose of rifaximin.
  
  
  METHODS
  This Randomized control trial was carried out at the Department of Gastroenterology and Hepatology, Shifa International Hospital, Islamabad, Pakistan from November 2012 to February 2014. Patients with known chronic liver disease with at least one episode of HE in the past were randomized to group A (rifaximin 550 mg OD) and group B (rifaximin 550 mg BD), after fulfilling the inclusion criteria. Each patient was followed for 6 months for any episode of HE. Patients in each group were identified for any breakthrough episode of encephalopathy during this period. Data were analyzed using SPSS version 16. Chi-squared test and t-test were applied where required to determine the significant difference between the two groups.
  
  
  RESULTS
  There were a total of 306 patients: 128 patients in Group A while 178 in group B. Majority of patients (75.81%) had hepatitis C virus with mean age of 52.30 ± 9.92, MELD score 13.58 ± 8.3, and 55.22% were in Child-Pugh B. Eighty-one patients had an episode of HE during the study period. There were 27 patients in group A and 54 patients in group B with breakthrough episode of HE (P = 0.088).
  
  
  CONCLUSIONS
  This study suggests that there is no significant difference in rifaximin once a day or twice daily dose in preventing HE.
authors: Department of Gastroenterology, Shifa International Hospital, Islamabad, Pakistan.
authors: Nasir
authors: N
authors: Khokhar
authors: Department of Gastroenterology, Shifa International Hospital, Islamabad, Pakistan.
authors: Muhammad Omar
authors: MO
authors: Qureshi
authors: Department of Gastroenterology, Shifa International Hospital, Islamabad, Pakistan.
authors: Shafiq
authors: S
authors: Ahmad
authors: Department of Gastroenterology, Shifa International Hospital, Islamabad, Pakistan.
authors: Aiza
authors: A
authors: Ahmad
authors: Department of Gastroenterology, Shifa International Hospital, Islamabad, Pakistan.
authors: Hamza Hassan
authors: HH
authors: Khan
authors: Department of Gastroenterology, Shifa International Hospital, Islamabad, Pakistan.
authors: Farzana
authors: F
authors: Shafqat
authors: Department of Gastroenterology, Shifa International Hospital, Islamabad, Pakistan.
authors: Muhammad
authors: M
authors: Salih
mesh_terms: D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D004334:Drug Administration Schedule; D016527:Drug Costs; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012294:Rifamycins / Q000008:administration & dosage*; D000078262:Rifaximin; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D012294:Rifamycins; D000078262:Rifaximin
keywords: chronic liver disease; hepatic encephalopathy; rifaximin