The End-Organ Impairment in Liver Cirrhosis: Appointments for Critical Care

Table 8

Oral antibiotics in hepatic encephalopathy.

Neomycin	There are no well-designed studies; Long-term use limited by nephrotoxicity and ototoxicity; Chronic hepatic encephalopathy: 1–4 g/day; Acute hepatic encephalopathy: 1–2 r every 4–6 hours
Metronidazole	Not approved for hepatic encephalopathy; Side effects: neurotoxicity and gastrointestinal disturbances.; Oral dose: 250 mg every 12 hours
Rifaximin	Multiple studies have demonstrated safety and efficacy for the treatment of acute and chronic encephalopathy; Two trials compared rifamixine versus rifamixin with lactulose and lactitiol and suggested that rifamixin produces equal or superior improvement of ammonia levels and hepatic encephalopathy in shorter time