title: [Ciprofloxacin vs cefazolin in the prevention of infection in cirrhotic patients with gastrointestinal bleeding].
abstract: OBJECTIVE
  To determine if prophylaxis with cefazolin produces a significant reduction in infections in cirrhotic patients with gastrointestinal bleeding when compared with ciprofloxacin.
  
  
  METHODS
  Randomized clinical trial. Patients 18 years or older with diagnosis of cirrhosis, gastrointestinal bleeding and no clinical or laboratory evidence of infection who were admitted to the gastrointestinal bleeding unit of HNERM between July 2008 and July 2010 were included. Patients were allocated to receive either i.v. ciprofloxacin 200 mg bid or i.v. cefazolin 1 gm tid for 7 days.
  
  
  RESULTS
  98 patients were included, 53 in the cefazolin group and 45 in the ciprofloxacin one. Age average was 66 +/- 10 years, 61% were male, 59,2% had ascites. Overall rate of infections was 14,3% (14/98). Rebleeding rate was 8,1% and mortality 4,1%. There were no differences in age, sex, Child Pugh score, ascites, hepatic encephalopathy nor in billirubin, albumin, PT and creatinine levels between the study groups. Infection rate in the cefazolin groups was 11,3% while in the ciprofloxacin one 17,8% (p=0,398).When Child-Pugh A and patients without ascites were excluded of the analysis, the cefalozin group had 22,2% of infections and 26,9% in the ciprofloxacin one (p=0,757).
  
  
  CONCLUSIONS
  there were no differences in infection rates between patients with prophylaxis with cefazolin and ciprofloxacin after an episode of gastrointestinal bleeding.
authors.affiliation: Servicio de Hígado-HNERM. EsSalud-Lima-Perú.
authors.forename: J
authors.initials: J
authors.lastname: Díaz Ferrer
authors.forename: R
authors.initials: R
authors.lastname: Román
authors.forename: C
authors.initials: C
authors.lastname: Bustíos
authors.forename: M
authors.initials: M
authors.lastname: Davalos
authors.forename: E
authors.initials: E
authors.lastname: Zumaeta
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D002437:Cefazolin / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002437:Cefazolin