Infectious sequelae after endoscopic sclerotherapy of oesophageal varices: role of antibiotic prophylaxis

Rolando, Nancy; Gimson, Alexander; Philpott‐Howard, John; Sahathevan, M.; Casewell, M.W.; Fagan, Elizabeth; Westaby, David; Williams, Roger

doi:10.1016/s0168-8278(05)80272-7

Cited by 68 publications

(32 citation statements)

References 15 publications

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“…Another more recent meta-analysis that also included two small randomized trials of antibiotic prophylaxis immediately prior to sclerotherapy [58,59] supported the conclusions of the previous meta-analysis and advocated the use of short-term prophylaxis in this setting [60]. Additionally, antibiotic prophylaxis with ofloxacin in patients with variceal bleeding has been shown to be associated with a lower probability of early rebleeding compared to patients not on prophylaxis [7].…”

Section: Patients Hospitalized With Gastrointestinal Hemorrhagementioning

confidence: 82%

Bacterial infections in cirrhosis: treatment and prophylaxis

García–Tsao

2005

Journal of Hepatology

102

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Section: Patients Hospitalized With Gastrointestinal Hemorrhagementioning

confidence: 82%

Bacterial infections in cirrhosis: treatment and prophylaxis

García–Tsao

2005

Journal of Hepatology

102

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“…They should be prevented and treated with proton pump inhibitors; the efficacy of sucralfate in treating these ulcers and preventing rebleeding is not clear [63] . Bacteremia may occur in up to 35% of patients and may be responsible for the development of abscesses and spontaneous bacterial peritonitis [64,65] . Less frequent complications are esophageal stenoses (2-10% of cases) and esophageal perforation [48] .…”

Section: Endoscopic Sclerotherapy (Es)mentioning

confidence: 99%

Endoscopic Management of Variceal Haemorrhage

Dell’Era

Iannuzzi

Franchis

2015

Journal of Gastroenterology and Hepatology Research

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One of the most important complications of portal hypertension, in the setting of liver cirrhosis or of non-cirrhotic portal hypertension, is upper gastrointestinal bleeding from ruptured gastroesophageal varices and portal hypertensive gastropathy. The management of the acute variceal bleeding is a multidisciplinary process that includes the initial assessment of the patient, effective resuscitation, timely diagnosis, control of bleeding and prevention of early rebleeding and complications such as infection, hepatorenal syndrome, or hepatic encephalopathy. Antibiotic prophylaxis, conservative targets for blood transfusions and combination therapy with vasoactive drugs and endoscopic treatments are the first-line measures in the management of acute variceal bleeding; transjugular intrahepatic portosystemic shunts should be proposed early to high-risk patients or as a rescue therapy for those who fail first-line treatment.

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“…To prevent sclerotherapy-related infections, parenteral antibiotics do not seem to be warranted, based on a controlled trial 78 ; rather, active bleeding seems to be the risk factor for infection, not sclerotherapy. Variceal banding may replace sclerotherapy.…”

Section: Preventionmentioning

confidence: 99%

Management of adult patients with ascites caused by cirrhosis

Runyon¹

1998

Hepatology

299

131

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Ascites is the most common of the major complications of cirrhosis. The development of ascites is an important landmark in the natural history of cirrhosis and has been proposed as an indication for liver transplantation. The initial evaluation of a patient with ascites should include a history, physical evaluation, and abdominal paracentesis with ascitic fluid analysis. Treatment should consist of abstinence from alcohol, sodium restricted diet, and diuretics. This regimen is effective in Ϸ90% of patients. The treatment options for the diuretic-resistant patients include serial therapeutic paracenteses, liver transplantation, and peritoneovenous shunting. (HEPATOLOGY 1998;27;264-272.) PREAMBLE These guidelines provide a data-supported approach to the care of patients with ascites. They are based on the following: 1) a formal review and analysis of the published world literature (1,045 papers) on ascites (Medline Search from 1966-1996, search terms included ascites, diet therapy, drug therapy, radiotherapy, surgery, and therapy); 2) the American College of Physician' s Manual for Assessing Health Practices and Designing Practice Guidelines 1 ; and 3) several published and draft guidelines, including the American Association for the Study of Liver Diseases' Policy Statement on Development and Use of Practice Guidelines and American Gastroenterological Association' s Policy Statement on Guidelines 2 ; and 4) 15 years of experience on the part of the author in the clinical and laboratory investigations of and care for patients with this problem.These guidelines, intended for use by physicians, suggest preferable approaches to the diagnostic, therapeutic, and preventative aspects of care. These guidelines are intended to be flexible, in contrast with ''standards of care,'' which are inflexible policies to be followed in almost every case. 1 Furthermore, these guidelines were developed for the care of adult patients with clinically detectable ascites. Although the general approach may be applicable to children, the pediatric data base is much smaller and there may be unanticipated differences between adults and children. Patients with ascites that is detected by imaging modalities alone, but not yet clinically evident, are not included because of the lack of published information regarding the natural history of this entity.Specific recommendations are based on relevant published information. In an attempt to standardize recommendations, the Practice Guidelines Committee of the American Association for the Study of Liver Diseases modified the categories of the Infectious Diseases Society of America' s Quality Standards. 3 These categories are reported with each recommendation, using the letters A through E to determine the strength of recommendation and roman numerals I through III to determine quality of evidence upon which recommendations are based, as follows: A, survival benefit; B, improved diagnosis; C, improvement in quality of life; D, relevant pathophysiologic parameters improved; E, impacts cost of heal...

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Infectious sequelae after endoscopic sclerotherapy of oesophageal varices: role of antibiotic prophylaxis

Cited by 68 publications

References 15 publications

Bacterial infections in cirrhosis: treatment and prophylaxis

Bacterial infections in cirrhosis: treatment and prophylaxis

Endoscopic Management of Variceal Haemorrhage

Management of adult patients with ascites caused by cirrhosis

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