Huang CH, Amodio P. Can rifaximin for hepatic encephalopathy be discontinued during broad-spectrum antibiotic treatment? World J Hepatol 2024; 16(2): 115-119 [PMID: 38495281 DOI: 10.4254/wjh.v16.i2.115]
Corresponding Author of This Article
Piero Amodio, Doctor, MD, Academic Editor, Additional Professor, Department of Clinical and Experimental Medicine, University of Padua, Via Giustiniani, 2, Padova 35122, Italy. piero.amodio@unipd.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Feb 27, 2024; 16(2): 115-119 Published online Feb 27, 2024. doi: 10.4254/wjh.v16.i2.115
Can rifaximin for hepatic encephalopathy be discontinued during broad-spectrum antibiotic treatment?
Chien-Hao Huang, Piero Amodio
Chien-Hao Huang, Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
Piero Amodio, Department of Clinical and Experimental Medicine, University of Padua, Padova 35122, Italy
Author contributions: Huang CH wrote the original manuscript; Amodio P reviewed and revised the manuscript.
Supported bythe Chang Gung Medical Research Project, No. CMRPG3M1931-1932; the National Science and Technology Council, No. MOST 110-2314-B-182A-093- and No. NMRPG3L0331.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Piero Amodio, Doctor, MD, Academic Editor, Additional Professor, Department of Clinical and Experimental Medicine, University of Padua, Via Giustiniani, 2, Padova 35122, Italy. piero.amodio@unipd.it
Received: November 19, 2023 Peer-review started: November 19, 2023 First decision: December 8, 2023 Revised: January 3, 2024 Accepted: January 24, 2024 Article in press: January 24, 2024 Published online: February 27, 2024
Core Tip
Core Tip: Rifaximin (RFX) is a gut-restricted adjunct to lactulose that minimizes hepatic encephalopathy (HE) recurrence with minimal systemic absorption. Despite established benefits, limited Food and Drug Administration approval for acute HE raises concern about its use in treating acute overt HE. Recent evidence challenges the routine use of RFX with broad-spectrum antibiotics, emphasizing their class-specific effects in critically ill patients. The study sheds light on the safety of discontinuing RFX during broad-spectrum antibiotic therapy in intensive care unit patients with liver disease and HE, and also prompts reevaluation of the role of RFX amid the overlapping antibiotic activity. This evidence underscores the need for further investigations to optimize the management of both HE and systemic infections in patients with liver disease, including those who are not critically ill.
