Objective: To determine the effect of Escherichia coli Nissle (Mutaflor, Ardeypharm GmbH, Herdecke, Germany) on the intestinal colonization, level of endotoxin and liver functions in patients with liver cirrhosis.
Methods: Thirty-nine patients with liver cirrhosis diagnosed by means of biopsy and clinical examinations were randomly allocated to treatment with E. coli Nissle or placebo for 42 days. Standard clinical examination, biochemical and hematological examinations, level of endotoxin and microbiological examination of the stool were performed before and after the treatment.
Results: In comparing the treatment of E. coli Nissle and placebo, significant improvement of the intestinal colonization (P<0.001) in the E. coli Nissle group was described. We found a trend of significant lowering of the endotoxemia (P=0.07) and improvement of liver functions evaluated by Child–Pugh score (P=0.06).
Conclusion: E. coli Nissle seems to be effective in the restoration of normal colonic colonization and can probably lower endotoxemia in cirrhotic patients.
Departments of aInternal Medicine and Gastroenterology
bMicrobiology, University Hospital, Brno
cInternal Medicine, Military Hospital Prague, Prague, Czech Republic
Correspondence to Professor Jan Lata, MD, PhD, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic
Tel: +420 532233465; fax: +420 535532221; e-mail: email@example.com
Received 17 February 2007 Accepted 19 June 2007