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Hepatic encephalopathy (HE) is a common complication of end-stage liver disease. Current treatment for HE includes nonabsorbable disaccharides. However, a recent systematic review indicated a lack of data supporting their efficacy (BMJ 2004; 328:1046). Oral antibiotics, such as neomycin and vancomycin, also have been used for HE, although concerns regarding their safety with long-term use have been raised. Another option, rifaximin (Xifaxan, a minimally absorbable antibiotic), is approved for nondysenteric diarrhea in the U.S. and for HE in 19 other countries.
To compare the efficacy of rifaximin with that of nonabsorbable disaccharides for HE, investigators conducted a meta-analysis of clinical trials performed between January 1978 and Octo…