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1 Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
2 Department of Infectious Disease, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
† These authors contributed equally to this work.
*Correspondence to: Wei-Fen Xie, Department of Gastroenterology, Shanghai Changzheng Hospital, 415 Fengyang Road, Shanghai 200003, China. Email: [email protected]
This study was supported by the Science and Technology guiding plan of Shanghai (124119a0702)
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/cdd.12294.
Keywords:
rifaximin;endotoxin;liver cirrhosis
BACKGROUND
Rifaximin therapy could improve gut-derived endotoxin in patients with liver cirrhosis. However, the experience of long-term rifaximin administration in Chinese population is limited.
AIM
To evaluate the efficacy, safety and tolerability of different doses of rifaximin in Chinese patients with hepatic cirrhosis.
METHODS
The random open prospective study included a 2-week treatment period and the next 4-week observation phase. Patients with liver cirrhosis were randomly assigned to low-dose rifaximin group, high-dose rifaximin group, and control group in a 1:1:1 ratio. Patients in low-dose and high-dose rifaximin group received 400 mg, 600 mg rifaximin two times a day for two weeks, respectively. All the other therapeutic strategies remained unchanged in the three groups as far as possible.
RESULTS
Sixty patients with liver cirrhosis were screened and 43 met the eligibility. After 2 weeks treatment, the serum level of endotoxin in low-dose rifaximin group (1.1 ± 0.8EU/ml) and high-dose rifaximin group (1.0 ± 0.8EU/ml) was significantly lower than that in control group (2.5 ± 1.8EU/ml), while no difference was shown between the two rifaximin treatment groups. The effect of high-dose rifaximin on endotoxemia could lasted to at least 4 weeks after drug withdrawal. A significant reduction in the abundance of the taxa Veillonellaceae and increase in the abundance of Bacteroides were shown after two weeks rifaximin therapy. The incidence of adverse events and serious adverse events was similar in the three groups.
CONCLUSIONS
Our findings indicated low-dose (800 mg/d) rifaximin could be analogous to high-dose (1200 mg/d) rifaximin to reduce the serum endotoxin level after two-weeks treatment. This article is protected by copyright. All rights reserved.