[Factors participating in development of bleeding varices in portal hypertension. Part I: bacterial infection and comparison of intravenous and peroral antibiotics effects--a randomised study].
An acute bleeding from oesophageal varices as a result of portal hypertension is a frequent and at the same time serious complication of cirrhosis of the liver. One of factors influencing this bleeding can be a bacterial infection. Endotoxines can increase portal pressure and so participate in development of bleeding and simultaneously deteriorate a patient's prognosis. An antibiotic treatment is a part of a treatment algorithm, however what antibiotics to administer and in what manner is unclear. A group of 46 patients who were admitted to a hospital for an acute bleeding from varices has been compared in the study to 48 cirrhosis patients hospitalised for other reasons. An infection incidence was high in both groups (63.0 % vs. 54.2 %), bleeding patients had more often positive hemoculture (17.3 % vs. 8.6 %), and statistically significantly more often positive findings in throat swab culture (36.9 % vs. 17.3 %, p = 0.04) which is an evidence of an increased pathology colonisation of these patients. Bleeding patients were randomised for peroral norfloxacin administration (n = 25) or an intravenous administration of a combination of ampicilin and sulbactam (n = 21). There was no difference in survival of both groups. Due to a high number of bacterial infections antibiotics administration has been indicated in these patients. Intravenous administration is probably of the same effect as peroral administration.
Lata
J
J
Interní gastroenterologická klinika Lékarské fakulty MU a FN Brno.
Juránková
J
J
Husová
L
L
Senkyrík
M
M
Díte
P
P
Dastych
M
M
Príbramská
V
V
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000382:microbiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000382:microbiology*; D007262:Infusions, Intravenous; D008103:Liver Cirrhosis / Q000150:complications / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009643:Norfloxacin / Q000008:administration & dosage; D013407:Sulbactam / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; C035444:sultamicillin; D000667:Ampicillin; D009643:Norfloxacin; D013407:Sulbactam