Vnitr Lek 2004, 50(11):830-835

[Factors participating in development of bleeding varices in portal hypertension. Part I: bacterial infection and comparison of intravenous and peroral antibiotics effects--a randomised study].

J Lata, J Juránková, L Husová, M Senkyrík, P Dítě, M Dastych, V Príbramská

Interní gastroenterologická klinika Lékarské fakulty MU a FN Brno.

An acute bleeding from oesophageal varices as a result of portal hypertension is a frequent and at the same time serious complication of cirrhosis of the liver. One of factors influencing this bleeding can be a bacterial infection. Endotoxines can increase portal pressure and so participate in development of bleeding and simultaneously deteriorate a patient's prognosis. An antibiotic treatment is a part of a treatment algorithm, however what antibiotics to administer and in what manner 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 administration (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 infections antibiotics administration has been indicated in these patients. Intravenous administration is probably of the same effect as peroral administration.

Keywords: Administration, Oral; Adult; Aged; Aged, 80 and over; Ampicillin /administration & dosage/; Anti-Bacterial Agents /administration & dosage/; Bacterial Infections /complications/; Esophageal and Gastric Varices /complications/; Female; Gastrointestinal Hemorrhage /etiology/; Humans; Hypertension, Portal /complications/; Infusions, Intravenous; Liver Cirrhosis /complications/; Male; Middle Aged; Norfloxacin /administration & dosage/; Sulbactam /administration & dosage/

Published: November 1, 2004  Show citation