Antibiotikaprofylakse til levercirrosepatienter med övre gastrointestinal blödning. Er der evidens for anvendelse?
Engelsk titel: Antibiotic prophylaxis for patients with liver cirrhosis and upper gastrointestinal hemorrhage. Is there evidence for its use?
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Författare:
Kofoed K
;
Kronborg G
Email: kkofoed@get2net.dk
Språk: Dan
Antal referenser: 24
Dokumenttyp:
Översikt
UI-nummer: 05021114
Sammanfattning
Bacterial infection is a common complication in patients with decompensated liver cirrhosis. Patients with liver cirrhosis and upper gastrointestinal bleeding are at special risk. Studies have shown that up to 66% become bacterially infected within 14 days after a bleeding episode. The presence of bacterial infection in bleeding cirrhotic patients is independently associated with early mortality and failure to control bleeding. It therefore seems reasonable to use antibiotic prophylaxis in this group of patients. An information retrieval identified nine controlled trials comparing antibiotics to a placebo or no intervention. All of the trials showed a decrease in mortality, although it was not statistically significant. Two recent meta-analyses show the same tendency; both demonstrate that antibiotic prophylaxis has a significant beneficial effect on decreasing mortality. The conclusion drawn is that antibiotic prophylaxis for this group of patients should be practised and that it can be practised without major ecological problems.