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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Rifaximin for Hepatic Encephalopathy
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Rifaximin for Hepatic Encephalopathy

机译：利福昔明治疗肝性脑病

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Objective: To evaluate the efficacy of rifaximin for the treatment of hepatic encephalopathy (HE).Data Sources: All articles were accessed via PubMed (January 1960-December 2008), Cochrane Library, and Iowa Drug Information Service (1966-December 2008) using the terms rifaximin and hepatic encephalopathy. In addition, reference citations from publications identified were reviewed.Study Selection and Data Extraction: All articles in English identified from the data sources were evaluated. Fifteen studies that evaluated the efficacy, safety, and/or cost-effectiveness of rifaximin for the treatment of HE are reviewed in this article.Data Synthesis: HE is a neuropsychiatric syndrome that develops in patients with acute or chronic liver failure. There are a number of accepted theories explaining the pathophysiology of HE. Currently, pharmacologic therapies include nonabsorbable disaccharides (lactulose) and antibiotics (neomycin and metronidazole). Recent studies have shown a possible benefit with a newer, nonabsorbable rifamycin derivative, rifaximin. It has a broad spectrum of activity against aerobic and anaerobic gram-positive and gram-negative organism. Clinical trials have compared rifaximin with lactulose, neomycin, or metronidazol for the treatment of HE. There have also been review articles addressing the cost-effectiveness of rifaximin compared with lactulose, including the cost of hospitalization. To date there have been no randomized, placebo-controlled studies that have assessed the efficacy and long-term safety outcomes of rifaximin in the treatment of HE; however, rifaximin has demonstrated similar efficacy and better safety profiles compared with other therapies, in particular, neomycin and lactulose.Conclusions: Patients with HE who are refractory to lactulose therapy or who have decreased tolerability to lactulose therapy may benefit from rifaximin as either adjunct therapy or salvage therapy.
机译：目的：评价利福昔明治疗肝性脑病（HE）的疗效。数据来源：所有文章均通过PubMed（1960年1月至2008年12月），Cochrane图书馆和爱荷华州药物信息服务局（1966年12月至2008年12月）访问。利福昔明和肝性脑病。此外，还对来自已鉴定出版物的参考文献进行了审查。研究选择和数据提取：对从数据源中鉴定出的所有英文文章进行评估。本文对15项评估利福昔明治疗HE的有效性，安全性和/或成本效益的研究进行了综述。数据综合：HE是一种在急性或慢性肝衰竭患者中发展的神经精神病综合症。有许多公认的理论可以解释HE的病理生理。当前，药物治疗包括不可吸收的二糖（乳果糖）和抗生素（新霉素和甲硝唑）。最近的研究表明，使用新型的，不可吸收的利福霉素衍生物利福昔明可能会带来益处。它对需氧和厌氧革兰氏阳性和革兰氏阴性生物具有广泛的活性。临床试验已经比较了利福昔明与乳果糖，新霉素或甲硝唑治疗HE的疗效。也有评论文章讨论了利福昔明与乳果糖相比的成本效益，包括住院费用。迄今为止，尚无随机，安慰剂对照的研究评估利福昔明治疗HE的疗效和长期安全性。然而，与其他疗法（特别是新霉素和乳果糖）相比，利福昔明具有相似的疗效和更好的安全性。结论：对乳果糖治疗无效或对乳果糖耐受性较弱的HE患者可从利福昔明中获益或抢救疗法。

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