Impact of Prophylactic Antibiotics in Cirrhotic Patients with Upper Gastrointestinal Hemorrhage / 医学研究杂志

ABSTRACT

Objective We investigated whether cirrhotic patients with upper gastrointestinal hemorrhage should be stratified for antibiotic prophylaxis based on Child-Pugh scores and etiology,to estimate risks of nosocomial infection,six-week re-bleeding,and mortality,and whether antibiotics prophylaxis have equal effects on patients of all Child-Pugh classes and etiologies.Methods A total of 316 hospitalized patients of cirrhosis patients with upper gastrointestinal hemorrhage were analyzed.The patients were classified as antibiotic group and control group,according to the patients whether received antibiotic prophylaxis or not.The two groups were monitored nosocomial infection rates,six-week re-bleeding rates and mortality rates.Results (1) Antibiotic prophylaxis reduces rates of nosocomial infection,six-week re-bleeding.(2)According to the etiology,cirrhosis can be divided into viral cirrhosis (VC) group and alcoholic cirrhosis (AC) group.The nosocomial infection rates and six-week re-bleeding rates of the VC group were lower in the antibiotic group.The nosocomial infection rates and the six-week re-bleeding rates of the AC group were lower in the antibiotic group.(3) According to Child-Pugh classification,patients were divided into Child-Pugh class A,B,C three groups.Child-Pugh class A groupthe nosocomial infection rates,six-week re-bleeding rates and mortality rates had no significant difference between the antibiotic group and control group.Child-Pugh class B groupthe nosocomial infection rates and six-week re-bleeding rates were lower in the antibiotic group.Child-Pugh class C groupthe nosocomial infection rates and six-week re-bleeding rates were lower in the antibiotic group.Conclusion Antibiotic prophylaxis reduces rates of nosocomial infection,six-week re-bleeding in cirrhosis patients with upper gastrointestinal hemorrhage,so the writer suggests short-term antibiotic prophylaxis.Antibiotics prophylaxis have equal effects on cirrhosis patients of different etiologies.While antibiotics prophylaxis have no equal effects on cirrhosis patients of all Child-Pugh classes.The nosocomial infection rates,six-week-rebleeding rates and mortality rates of Child-Pugh class A are low.The recommendation for routine antibiotic prophylaxis for this subgroup requires further evaluation.