Antibiotic of choice in cirrhotic patient to prevent encephalopathy:
Neomycin
Ampicillin
Metronidazole
Rifaximin
Treatment of hepatic encephalopathy 1. Correct precipitating factors 2. Use lactulose- results in colonic acidification. 2. Poorly absorbed antibiotics- neomycin and metronidazole. More recently, rifaximin at 550 mg twice daily has been very effective in treating encephalopathy without the known side effects of neomycin or metronidazole.
Cirrhosis