Rifaximin: A nonabsorbable, broad-spectrum antibiotic for reduction in the risk for recurrence of overt hepatic encephalopathy
Rifaximin is a broad-spectrum antibiotic that has been approved by FDA for reduction in the risk for recurrence of overt hepatic encephalopathy, a debilitating disorder caused by the inability of the liver to remove bacterial-derived toxic by-products, speci cally ammonia. It is a nonabsorbable antibiotic that provides activity locally in the gut due to its negligible systemic absorption. Rifaximin has a favorable side-effect pro le and a low potential for drug interactions. A recent landmark phase 3 trial in patients in remission from recurrent hepatic encephalopathy demonstrated that rifaximin at a dose of 550 mg twice daily is significantly more effective than placebo in maintaining remission and reducing the risk of hospitalization. Rifaximin's approval by FDA in March 2010, offers clinicians the first pharmacologic treatment for hepatic encephalopathy in more than 30 years.