Soriano G, Guarner C, Tomas A, et al. Norfloxacin prevents bacterial infection in cirrhotics with gastrointestinal hemorrhage. Gastroenterology 1992;103:1267-1272. Cirrhotic patients who are hospitalized for GI bleeding often have infections such as UTI, SBP, and pneumonia secondary to gram- negative bacilli. In this trial, patients with UGIB underwent EGD with intervention (such as sclerotherapy for esophageal and gastric varices, etc.), and group 1 received norfloxacin post-endoscopy, while group 2 did not. Compared to the control group, the norfloxacin group showed a decreased incidence of overall infection (10% vs. 37.2%, p = 0.001), bacteremia, and/or SBP (3.3% vs. 16.9%, p < 0.05), and UTI (0% vs. 18.6%, p = 0.001). Mortality did not differ in this study, but a subsequent meta-analysis showed decreased mortality with prophylactic antibiotics (Soares-Weiser K, et al. Scandinavian Journal of Gastroenterology 2003;38:193-200). At our institution, piperacillin is often used for gram-negative coverage, and quinolones are less favored given our resistance panel.
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Soriano G, Guarner C, Tomas A, et al. Norfloxacin prevents bacterial infection in cirrhotics with gastrointestinal hemorrhage. Gastroenterology 1992;103:1267-1272. Cirrhotic patients who are hospitalized for GI bleeding often have infections such as UTI, SBP, and pneumonia secondary to gram-negative bacilli. In this trial, patients with UGIB underwent EGD with intervention (such as sclerotherapy for esophageal and gastric varices, etc.), and group 1 received norfloxacin post-endoscopy, while group 2 did not. Compared to the control group, the norfloxacin group showed a decreased incidence of overall infection (10% vs. 37.2%, p = 0.001), bacteremia, and/or SBP (3.3% vs. 16.9%, p < 0.05), and UTI (0% vs. 18.6%, p = 0.001). Mortality did not differ in this study, but a subsequent meta-analysis showed decreased mortality with prophylactic antibiotics (Soares-Weiser K, et al. Scandinavian Journal of Gastroenterology 2003;38:193-200). At our institution, piperacillin is often used for gram-negative coverage, and quinolones are less favored given our resistance panel.
Related Documents
