Current aspects of antibiotic prophylaxis for upper gastrointestinal bleeding in cirrhosis patients

Almeida, D.; Paraná, Raymundo

doi:10.1590/s1413-86702002000500009

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Recommended prophylactic antibiotics protocols include 200 mg of IV ciprofloxacin, or 400 mg of oral norfloxacin, both are given twice a day. When patients have advanced decompensated cirrhosis, ceftriaxone showed better outcomes than norfloxacin [13] .…”

Section: Antibiotic Prophylaxismentioning

confidence: 94%

Emergency Management of Upper GI Variceal Bleeding

Alghazal¹,

Susi

Alshaikhnasser

et al. 2018

Egyptian Journal of Hospital Medicine

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Background: Upper gastrointestinal bleeding is the most common gastrointestinal cause of admission in emergency departments worldwide with about 10% inpatient mortality rate that has not decreased during the last three decades. Aim: In this review, we aim to study the pathophysiology behind the development of upper gastrointestinal bleeding, and explore the approach to its management in emergency situation. Materials and Methods: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: upper gastro intestinal bleeding, variceal bleeding, emergency management of gastrointestinal hemorrhage, varices, esophageal bleeding. Results: Managing patients with bleeding varices must have two goals that should be considered: to stop the bleeding, and to prevent rebleeding since 60% of patients will rebleed after the acute bleeding was stopped leading to a mortality rate of 33%, unless adequately treated. Conclusion: Bleeding varices are always considered urgent emergencies due to associated morbidity and mortality. Moreover, bleeding varices can cause hemodynamic instability and end-organ failure. The most important intervention is therapeutic endoscopy. Other approaches include vasoactive drugs, and prophylactic antibiotics. After acute management of the bleeding, patients should undergo further evaluation and treatment to prevent the recurrence of another bleeding.

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Section: Antibiotic Prophylaxismentioning

confidence: 94%

Emergency Management of Upper GI Variceal Bleeding

Alghazal¹,

Susi

Alshaikhnasser

et al. 2018

Egyptian Journal of Hospital Medicine

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“…It is important to note that clinically, antibiotics have demonstrated some success in the treatment of ALD patients [26][27][28] . The studies above used different approaches, but have shown very similar results when comparing the short-term and long-term effects of ethanol.…”

Section: Two-hit Animal Modelsmentioning

confidence: 99%

Alcohol metabolites and lipopolysaccharide: Roles in the development and/or progression of alcoholic liver disease

Schaffert

Duryee

Hunter

et al. 2009

WJG

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The onset of alcoholic liver disease (ALD) is initiated by different cell types in the liver and a number of different factors including: products derived from ethanol-induced inflammation, ethanol metabolites, and the indirect reactions from those metabolites. Ethanol oxidation results in the production of metabolites that have been shown to bind and form protein adducts, and to increase inflammatory, fibrotic and cirrhotic responses. Lipopolysaccharide (LPS) has many deleterious effects and plays a significant role in a number of disease processes by increasing inflammatory cytokine release. In ALD, LPS is thought to be derived from a breakdown in the intestinal wall enabling LPS from resident gut bacterial cell walls to leak into the blood stream. The ability of adducts and LPS to independently stimulate the various cells of the liver provides for a two-hit mechanism by which various biological responses are induced and result in liver injury. Therefore, the purpose of this article is to evaluate the effects of a two-hit combination of ethanol metabolites and LPS on the cells of the liver to increase inflammation and fibrosis, and play a role in the development and/or progression of ALD.

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Immunological response in alcoholic liver disease

Duryee

Klassen

Thiele

2007

WJG

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The development of alcoholic liver disease (ALD) can be attributed to many factors that cause damage to the liver and alter its functions. Data collected over the last 30 years strongly suggests that an immune component may be involved in the onset of this disease. This is best evidenced by the detection of circulating autoantibodies, infiltration of immune cells in the liver, and the detection of hepatic aldehyde modified proteins in patients with ALD. Experimentally, there are numerous immune responses that occur when proteins are modified with the metabolites of ethanol. These products are formed in response to the high oxidative state of the liver during ethanol metabolism, causing the release of many inflammatory processes and potential of necrosis or apoptosis of liver cells. Should cellular proteins become modified with these reactive alcohol metabolites and be recognized by the immune system, then immune responses may be initiated. Therefore, it was the purpose of this article to shed some insight into how the immune system is involved in the development and/or progression of ALD.

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Current aspects of antibiotic prophylaxis for upper gastrointestinal bleeding in cirrhosis patients

Cited by 3 publications

References 18 publications

Emergency Management of Upper GI Variceal Bleeding

Emergency Management of Upper GI Variceal Bleeding

Alcohol metabolites and lipopolysaccharide: Roles in the development and/or progression of alcoholic liver disease

Immunological response in alcoholic liver disease

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