treatment of lactulose resistant chronic hepatic encephalopathy

Vancomycin hydrochloride (2 g daily) was administered to 12 patients with cirrhosis and lactulose resistant portal systemic encephalopathy in a double blind crossover trial. AU 12 patients showed a remarkable clinical improvement after vancomycin treatment. The mean (SE) electroencephalographic (EEG) frequency changed from 6*3 (0.2) to 8*5 (0.2) cps (p<0001) and the mean arterial ammonia concentration from 152 (4) tg/ml to 97 (8) ,ug/ml (p<0-001). Their clinical condition deteriorated when treatment was switched to lactulose, returning to the previous slower EEG frequency and high arterial ammonia concentrations. Vancomycin seems to be effective in chronic portal systemic encephalopathy in patients who are not helped by

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