Effects of enteral and intravenous antimicrobial treatment on survival following intestinal ischemia in rats

Plonka, Andrzej J.; Schentag, Jerome J.; Messinger, Sol; Adelman, Martin H.; Francis, Kathryn L.; Williams, James S.

doi:10.1016/0022-4804(89)90059-0

Cited by 34 publications

(30 citation statements)

References 23 publications

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“…Intravenous fluids and bowel rest are advised. Some clinicians use antibiotics to treat bowel flora, based on experimental models showing that antibiotics reduce the extent and severity of bowel damage [38,39]. No randomized, controlled trials have assessed this treatment, and use of antibiotics for patients with CI remains unproven.…”

Section: Medical Managementmentioning

confidence: 99%

Colon Ischemia: Recent Insights and Advances

Feuerstadt

Brandt

2010

Curr Gastroenterol Rep

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Ischemic colitis is the most common manifestation of ischemic injury to the gastrointestinal tract, and the variety of defined causes is increasing. Local hypoperfusion and reperfusion injury are both thought to contribute to the disease process, which manifests with a wide spectrum of injury including reversible colopathy (subepithelial hemorrhage and edema), transient colitis, chronic colitis, stricture, gangrene, and fulminant universal colitis. The distribution is typically segmental. Older studies showed that any portion of the colon can be involved; recently, it was established that the site of involvement and prognosis can be correlated. In particular, isolated involvement of the right side of the colon was shown to have a different presentation and worse outcome than ischemic colitis involving other segments. Diagnosis is usually made clinically and supported by radiologic imaging and colonoscopic evaluation. Most patients respond to conservative supportive therapy, although some with severe disease require surgical intervention.

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Section: Medical Managementmentioning

confidence: 99%

Colon Ischemia: Recent Insights and Advances

Feuerstadt

Brandt

2010

Curr Gastroenterol Rep

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“…Experimental studies have shown decreased mortality with peri‐ischaemic event fluid resuscitation and antibiotic treatment 33 . Typically, intravenous antibiotic coverage for both Gram‐negative and anaerobic organisms is used, but one study in rats with SMA transection comparing gentamicin and metronidazole suggested that antibiotic coverage for anaerobes and not Gram‐negative bacteria may be more important in the treatment of mesenteric ischaemia 34 . Animals treated with either enterically injected or intravenous metronidazole or a combination of metronidazole and gentamicin survived significantly longer than animals treated with gentamicin alone.…”

mentioning

confidence: 99%

Review article: diagnosis and management of mesenteric ischaemia with an emphasis on pharmacotherapy

Kozuch

Brandt

2005

Aliment Pharmacol Ther

156

101

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Summary Mesenteric ischaemia results from decreased blood flow to the bowel, causing cellular injury from lack of oxygen and nutrients. Acute mesenteric ischaemia (AMI) is an uncommon disorder with high morbidity and mortality, but outcomes are improved with prompt recognition and aggressive treatment. Five subgroups of AMI have been identified, with superior mesenteric artery embolism (SMAE) the most common. Older age and cardiovascular disease are common risk factors for AMI, excepting acute mesenteric venous thrombosis (AMVT), which affects younger patients with hypercoaguable states. AMI is characterized by sudden onset of abdominal pain; a benign abdominal exam may be observed prior to bowel infarction. Conventional angiography and more recently, computed tomography angiography, are the cornerstones of diagnosis. Correction of predisposing conditions, volume resuscitation and antibiotic treatment are standard treatments for AMI, and surgery is mandated in the setting of peritoneal signs. Intra‐arterial vasodilators are used routinely in the treatment of non‐occlusive mesenteric ischaemia (NOMI) and also are advocated in the treatment of occlusive AMI to decrease associated vasospasm. Thrombolytics have been used on a limited basis to treat occlusive AMI. A variety of agents have been studied in animal models to treat reperfusion injury, which sometimes can be more harmful than ischaemic injury. Chronic mesenteric ischaemia (CMI) usually is caused by severe obstructive atherosclerotic disease of two or more splanchnic vessels, presents with post‐prandial pain and weight loss, and is treated by either surgical revascularization or percutaneous angioplasty and stenting.

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“…The role of antibiotics is unclear. In experimental studies, antibiotics have demonstrated to offer protection against bacterial translocation [18] and prolong survival after intestinal ischemia in rats [19]. In fact, its common use is recommended by many authors [3,20].…”

Section: Discussionmentioning

confidence: 99%

Ischemic Colitis: Characteristics and Predictive Factors of Severity, in Hospital Mortality and Relapse

Cubiella¹,

Calvo²,

Vázquez³

et al. 2009

TOGASJ

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Objective: The study was designed to describe a cohort of patients with ischemic colitis (I.C.) that required admission and the factors related to severity and mortality. Also, we tried to define the risk of relapse after discharge and the variables associated.Methods: Descriptive and retrospective study of patients with I.C. diagnosed between January 1996 and March 2003. Qualitative variables were analyzed using Fisher exact test and parametric variables were analyzed using Student´s t-test. Those variables statistically significant were included in a Cox regression model. Conclusions:We identified several predictive factors that can be used to stratify patients on admission. We found a relation between treatment with aspirin, antihypertensive drugs and relapse that should be confirmed in prospective studies.

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Effects of enteral and intravenous antimicrobial treatment on survival following intestinal ischemia in rats

Cited by 34 publications

References 23 publications

Colon Ischemia: Recent Insights and Advances

Colon Ischemia: Recent Insights and Advances

Review article: diagnosis and management of mesenteric ischaemia with an emphasis on pharmacotherapy

Ischemic Colitis: Characteristics and Predictive Factors of Severity, in Hospital Mortality and Relapse

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