Mean Blood Ammonia Level After Treatment With Rifaximin Versus Neomycin In Chronic Liver Disease Patients Presenting With Hepatic Encephalopathy

Objective: To compare Rifaximin versus neomycin in chronic liver disease (CLD) patients presenting with hepatic Encephalopathy. Methodology: This Randomized controlled trial was conducted at North Medical Ward, King Edward Medical University/ Mayo Hospital Lahore from June to December 2013. Total 100 patients of CLD with Hepatic Encephalopathy were included through non-probability, purposive sampling and were named group A & B by random division. In Group A, patients received conventional Antibiotic Neomycin 3000mg 6-hourly daily while in Group B; patients received Rifaximin 600mg 12-hourly daily orally for 21 days. Blood Ammonia levels of both groups after 21 days treatment were analyzed by the software SPSS version 16. Results: The mean age of patients was 54.23 +/- 13.70 years with 54 (54%) male and 46 (46%) females. Out of 54 male patients, 28 (52%) were randomized to Rifaximin and 26 (48%) were randomized to Neomycin. Similarly, out of 46 female patients, 22 (48%) were randomized to Rifaximin and 24 (52%) were randomized to Neomycin. The serum Ammonia level after treatment with Rifaximin was 58.00 (14-117) g/dl whereas with Neomycin was 87.00(38-381) g/dl. Significant difference was found between both groups (p-value<0.0001). Conclusion: Rifaximin is a better treatment option in CLD patients with Hepatic Encephalopathy as compared to conventional Neomycin.