title: Does low-dose rifaximin ameliorate endotoxemia in patients with liver cirrhosis: a prospective study.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zeng
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Xia Jiao
authors.initials: XJ
authors.lastname: Tang
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Sheng
authors.affiliation: Department of Infectious Disease, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wu
authors.initials: W
authors.lastname: Ni
authors.affiliation: Department of Infectious Disease, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Hai Guang
authors.initials: HG
authors.lastname: Xin
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wei Zhong
authors.initials: WZ
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Cai Feng
authors.initials: CF
authors.lastname: Jiang
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Shi
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Shi
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yue Xiang
authors.initials: YX
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Zong Li
authors.initials: ZL
authors.lastname: Yuan
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wei Fen
authors.initials: WF
authors.lastname: Xie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016207:Cytokines / Q000097:blood; D004305:Dose-Response Relationship, Drug; D019446:Endotoxemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D064307:Microbiota / Q000187:drug effects; D008875:Middle Aged; D011446:Prospective Studies; D012294:Rifamycins / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000078262:Rifaximin; D051193:Toll-Like Receptors / Q000097:blood; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D016207:Cytokines; D012294:Rifamycins; D051193:Toll-Like Receptors; D000078262:Rifaximin
keywords: endotoxins; liver cirrhosis; rifaximin