Clinical

Bacterial infection common in patients with variceal bleeding

Last Updated: 2005-11-24 10:15:08 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Bacterial infection is often encountered in patients with liver cirrhosis hospitalized because of variceal bleeding or for other indications, Czech researchers report, and antibiotic therapy is indicated in this setting.

Dr. Jan Lata of University Hospital Brno and colleagues note in the November issue of the European Journal of Gastroenterology and Hepatology that bleeding from esophageal varices is a frequent complication of cirrhosis and has a high mortality rate. Bacterial infection may be among possible precipitating factors, and the researchers sought to determine the prevalence of such infection and the most effective treatment route.

The team studied data on 48 cirrhotic patients admitted because of variceal bleeding associated with portal hypertension and another 48 control patients with cirrhosis admitted for other reasons.

Bleeding was treated and the patients were also randomized to therapy with oral norfloxacin or intravenous ampicillin and sulbactam.

Bacterial infection rates were high in both groups but was higher in patients with bleeding (63% versus 54.2%). More bleeding patients had positive blood cultures than did controls (17.3% versus 8.6%). This was also true of throat smear findings (36.9% versus 17.3%).

There were no differences in mortality between patients given different antibiotic regimens. However, the researchers conclude that "antibiotic therapy is fully indicated due to the high number of positive bacterial findings."

Eur J Gastroenterol Hepatol 2005;17:1105-1110.