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Gastroenterology Research and Practice
Volume 2013, Article ID 236963, 9 pages
Review Article

Rifaximin versus Nonabsorbable Disaccharides for the Treatment of Hepatic Encephalopathy: A Meta-Analysis

Department of Gastroenterology, Shanghai tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China

Received 14 December 2012; Revised 7 March 2013; Accepted 7 March 2013

Academic Editor: Edoardo Giovanni Giannini

Copyright © 2013 Dong Wu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Many studies have found that the antibiotic rifaximin is effective for the treatment of hepatic encephalopathy. However, there is no uniform view on the efficacy and safety of rifaximin. Methods. We performed a meta-analysis through electronic searches to evaluate the efficacy and safety of rifaximin in comparison with nonabsorbable disaccharides. Results. A total of 8 randomized controlled trials including 407 patients were included. The efficacy of rifaximin was equivalent to nonabsorbable disaccharides according to the statistical data (risk ratio (RR): 1.06, 95% CI: 0.94–1.19; ). Analysis showed that patients treated with rifaximin had better results in serum ammonia levels (weighted mean difference (WMD): −10.63, 95% CI: −30.63–9.38; ), mental status (WMD: −0.32, 95% CI: −0.67–0.03; ), asterixis (WMD: −0.12, 95% CI: −0.31–0.08; ), electroencephalogram response (WMD: −0.21, 95% CI: −0.34–−0.09; ), and grades of portosystemic encephalopathy (WMD: −2.30, 95% CI: −2.78–−1.82; ), but only the last ones had statistical significance. The safety of rifaximin was better than nonabsorbable disaccharides (RR: 0.19, 95% CI: 0.10–0.34; ). Conclusion. Rifaximin is at least as effective as nonabsorbable disaccharides, maybe better for the treatment of hepatic encephalopathy. And the safety of rifaximin is better.