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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitř. Lék., 49, 2003, No. 10, p. 808 - 812 |
Antibiotic Prophylaxis
in Patients with Acute Bleeding due to Portal Hypertension - Our Experience Husová L.1, Šenkyřík M.1, Lata J.1, Husa P.2, Juránková J.3, Dastych M.4 1Interní gastroenterologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Petr Dítě, DrSc. 2Klinika infekčních chorob Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Pavel Chalupa, CSc.3Mikrobiologické oddělení FN Brno, pracoviště Bohunice, přednosta prim. MUDr. Alena Ševčíková4Oddělení klinické biochemie, FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Milan Dastych, CSc. |
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Summary: Acute bleeding from upper part of gastrointestinal tract is a frequent and serious complication
affecting 20 to 60 % of patients with liver cirrhosis and portal hypertension. It is associated with
a high death rate of 30 to 50 % and a frequent relapse of bleeding occurs in up to 40 % of these
patients. The most recent meta-analyses have shown that bacterial infection is an independent
factor in the failure of blood hemostasis and significantly influenced mortality in these patients.
The authors investigated 25 patients with acute bleeding from the upper part of gastrointestinal
tract due to portal hypertension in patients with liver cirrhosis. Irrespective of the proved bacterial
infection the patients were given antibiotic prophylaxis. In 13 patients the authors administered
norfloxacin orally and 12 patients were treated intravenously with ampicilin/sulbactam. The
prophylaxis of the bleeding cirrhotic patients by norfloxacin (orally) resulted in a statistically
significant prevention of early relapse as compared with the therapy by ampicilin/sulbactam
(intravenously). The death rate reached 40% in spite of the antibiotic prophylaxis. There was no
significant difference in the death rate between the two groups with different treatments.
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