Comparison between neomycin and lactulose in 173 patients with hepatic encephalopathy - A randomized clinical study

Francesco Orlandi, Umberto Freddara, Maria Teresa Candelaresi, Antonio Morettini, Gino R. Corazza, Aurelio Di Simone, Giorgio Dobrilla, Giorgio Cavallini

Research output: Contribution to journalArticlepeer-review

Abstract

A randomized study was performed in order to compare the course of hepatic encephalopathy in patients treated with neomycin plus magnesium sulfate or with lactulose. Admission criteria were: morphological diagnosis of cirrhosis and absence of comorbidity, of contraindications to drugs, or of previous treatments which could influence the outcome. The treatment groups were similar in terms of clinical characteristics, fatalities, recovery rate from grade 1 encephalopathy, and disappearance rate of neuropsychiatric signs. Transitions from severe to grade 1 or 0 encephalopathy showed a 0.17 (NS) difference in favor of neomycin. Early therapy and evidence of precipitating factors showed a favorable prognostic significance. Ascites, hyperbilirubinemia, poor nutritional state, and hypoprothrombinemia showed bad prognostic significance. This is the first large-scale investigation on hepatic encephalopathy. It demonstrated a similar effectiveness of the two drugs in grade 1 encephalopathy and provides a basis for drug selection in the current management of the syndrome.

Original languageEnglish
Pages (from-to)498-506
Number of pages9
JournalDigestive Diseases and Sciences
Volume26
Issue number6
DOIs
Publication statusPublished - Jun 1981

ASJC Scopus subject areas

  • Gastroenterology

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