Final answer:
Neomycin sulfate is an antibiotic used to reduce ammonia-producing bacteria in the gut, thus lowering blood ammonia levels and alleviating symptoms of hepatic encephalopathy. Due to potential side effects, it is less frequently used than other treatments like lactulose and rifaximin.
Step-by-step explanation:
How Neomycin Sulfate is Used in Hepatic Encephalopathy
Hepatic encephalopathy is a neuropsychiatric abnormality that occurs in the presence of liver failure, which can be acute or chronic such as with cirrhosis. In managing this condition, neomycin sulfate acts therapeutically to reduce the levels of ammonia within the gut. This antibiotic works by eliminating bacteria in the gut that produce ammonia, consequently lowering ammonia absorption into the bloodstream. When the liver is compromised, it cannot effectively eliminate toxins like ammonia, and by reducing gut-produced ammonia, neomycin sulfate helps diminish the neuropsychiatric symptoms associated with hepatic encephalopathy. Although used less frequently today due to its potential for nephrotoxicity and ototoxicity, it remains an option especially when other treatments are not suitable.
It is important to note that other treatments are now more commonly employed given the side effects associated with neomycin. Lactulose and rifaximin are examples of other medications that can also help reduce ammonia levels in the treatment of hepatic encephalopathy. Lactulose works by acidifying the contents of the bowel and trapping ammonia in the gut, while rifaximin is another antibiotic that has a similar effect to neomycin but with a better side effect profile.