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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitř. Lék., 50, 2004, No. 11, p. 830 - 835 |
Factors Participating in Development of Bleeding Varices in Portál Hypertension. Part I: Bacterial Infection and Comparison of Intravenous and Peroral Antibiotics Effects - A Randomised Study Lata J.1, Juránková J.2, Husová L.1, Šenkyřík M.1, Dítě P.1, Dastych M.3, Příbramská V.1 1Interní gastroenterologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Petr Dítě, DrSc. 2Oddělení klinické mikrobiologie FN Brno, pracoviště Bohunice, přednosta prim. MUDr. Alena Ševčíková, CSc. 3Oddělení klinické biochemie FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Milan Dastych, CSc. |
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Summary: An acute bleeding from oesophageal varices as a result of portál hypertension is a frequent and at the samé time serious complication of cirrhosis of the liver. One of factors influencing this bleeding can be a bacterial infection. Endotoxines can increase portál pressure and so participate in development of bleeding and simultaneously deteriorate a patienťs prognosis. An antibiotic treat-ment is a part of a treatment algorithm, however what antibiotics to administer and in what man-ner 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 admi-nistration (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 in-fections antibiotics administration has been indicated in these patients. Intravenous administration is probably of the samé effect as peroral administration.
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