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Previous Volume 361:1512-1513 October 8, 2009 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Lucey et al. (June 25 issue)¹ provide an excellent review of alcoholic hepatitis, but their recommendation of using gut-cleansing antibiotics for the treatment of hepatic encephalopathy is outdated and not evidence-based. Although neomycin has been used to treat hepatic encephalopathy for many years, no controlled studies have found it to be effective, as compared with standard treatment alone. A randomized trial² comparing neomycin at a dose of 6 g per day with placebo showed no difference in outcomes between the two study groups. A downside to using neomycin is its association with ototoxicity and nephrotoxicity.

Metronidazole, vancomycin,³ . . . [Full Text of this Article]

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