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; P = 0.34). 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; P = 0.30), mental status (WMD: -0.32, 95% CI: -0.67-0.03; P = 0.07),
asterixis (WMD: -0.12, 95% CI: -0.31-0.08; P = 0.23), electroencephalogram response (WMD: -0.21, 95% CI: -0.34--0.09; P = 0.0007), and grades of
portosystemic encephalopathy (WMD: -2.30, 95% CI: -2.78--1.82; P < 0.00001), 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; P < 0.00001). 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.