Low-Dose Rifaximin Cuts Endotoxin Level in Cirrhosis
(HealthDay News) — For patients with liver cirrhosis, low-dose rifaximin is comparable to high-dose rifaximin for reducing serum endotoxin levels, according to a study published online Oct. 16 in the Journal of Digestive Diseases.
Xin Zeng, from the Second Military Medical University in Shanghai, and colleagues examined the efficacy, safety, and tolerability of different rifaximin doses in patients with hepatic cirrhosis. Sixty Chinese patients with liver cirrhosis underwent screening and 43 were eligible for inclusion. Patients were randomized in a 1:1:1 ratio to low-dose rifaximin (400mg twice daily), high-dose rifaximin (600mg twice daily), or control. The treatment period was 2 weeks and the observation phase was 4 weeks.
The researchers found that the serum level of endotoxin was significantly lower in the low-dose rifaximin group and high-dose rifaximin group compared with the control group (1.1 ± 0.8 and 1.0 ± 0.8, respectively, vs. 2.5 ± 1.8 EU/mL) after 2 weeks of treatment; there was no difference between the treatment groups. The high-dose rifaximin effect on endotoxemia lasted 4 weeks or more following drug withdrawal. After 2 weeks of rifaximin therapy there was a significant reduction in the abundance of the taxa Veillonellaceae and an increase in the abundance of Bacteroides. The three groups had similar incidence of adverse events and serious adverse events.
"Our findings indicated low-dose (800mg/day) rifaximin could be analogous to high-dose (1,200mg/day) rifaximin to reduce the serum endotoxin level after two weeks [of] treatment," the authors write.