Oral, nonabsorbable antibiotics prevent infection in cirrhotics with gastrointestinal hemorrhage

✍ Scribed by Antoni Rimola; Felipe Bory; Josep Teres; Rosa M. Perez-Ayuso; Vicente Arroyo; Joan Rodes

• Publisher: John Wiley and Sons
• Year: 1985
• Tongue: English
• Weight: 608 KB
• Volume: 5
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840050320

✦ Synopsis

To investigate if oral, nonabsorbable antibiotics prevent bacterial infections in cirrhotics with gastrointestinal hemorrhage, 140 consecutive patients were randomly allocated into two groups: 68 patients (Group I) were given oral, non absorbable antibiotics (gentamicin + vancomycin + nystatin or neomycin + colistin + nystatin) from the inclusion into the trial up to 48 hr after cessation of the hemorrhage, or until emergency surgery or death in those cases who continued bleeding; and 72 patients (Group 11) did not receive oral, nonabsorbable antibiotics. Both groups were similar in relation to clinical and laboratory data and characteristics of the hemorrhage. The incidence of infection was significantly lower in Group I than in Group I1 (11 patients in Group I and 25 in Group I1 developed proved infections; p < 0.025). This difference was due to the fact that spontaneous bacteremia and peritonitis and urinary tract infection caused by enteric bacteria occurred almost exclusively in Group 11. Two patients of Group I and 10 of Group I1 developed spontaneous bacteremia and/or peritonitis caused by enteric bacteria (p c 0.025). These results indicate that prophylactic administration of oral, nonabsorbable antibiotics markedly reduces the incidence of infections caused by enteric bacteria in cirrhotic patients with gastrointestinal hemorrhage.