Hepatic encephalopathy, a complex neuropsychiatric syndrome, arises from the accumulation of toxic substances, primarily ammonia, due to impaired liver function. Elevated ammonia levels in the blood lead to astrocyte swelling and dysfunction, contributing to cognitive and neurological disturbances in patients with advanced liver disease. Rifaximin, an antibiotic, is commonly used to reduce the production of ammonia-forming gut bacteria. However, in certain hospice settings, alternatives to rifaximin might be considered due to various factors, including patient preferences, contraindications, unavailability of the drug, or comparative cost-effectiveness. This resource was developed to review possible rifaximin alternative treatments.
..... Download Full PDF