Rifaximin acts by binding to the beta-subunit of bacterial DNA dependent RNA polymerase resulting in inhibition of bacterial RNA synthesis. Rifaximin has been shown to be active against the non invasive strain of Escherichia coli (enterotoxigenic and enteroaggregative strains). Rifaximin is believed to affect gut bacteria resulting in a decreased production and/or absorption of bacterial derived neurotoxins, including ammonia, responsible for the neurocognitive and neuromuscular dysfunction seen in patients with Hepatic Encephalopathy.
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