Blood ammonia levels in hepatic cirrhosis: their control by the oral administration of neomycin.

THE relation between elevated blood ammonia concentrations and the occurrence of hepatic coma has called attention to the sites of ammonia production. The production of ammonia by bacterial enzymatic action upon urea and other nitrogenous compounds in the gastrointestinal tract serves to make this site a major source of blood ammonia.1 This has led several authors2 3 4 to suggest that antibacterial agents effective against intestinal organisms might be beneficial in this type of coma. Silen et al.5 have demonstrated in dogs that ingested neomycin is highly effective in reducing ammonia levels in blood draining various intestinal sites, and subsequently we observed . . .