Prophylactic Antibiotics in the Endoscopic Secondary Prevention of Cirrhotic Patients With Varices: a Retrospective Study

Second Affiliated Hospital, School of Medicine, Zhejiang University480 enrolled

Overview

Whether prophylactic antibiotics should be administered in the endoscopic secondary prevention of GVB or not is unclear. In this retrospective study, we are aimed to evaluate whether prophylactic antibiotics confer advantages in the endoscopic secondary prevention of cirrhotic patients with gastroesophageal varices.

Study Type

OBSERVATIONAL

Enrollment

480

Conditions

Cirrhosis, Liver Hypertension, Portal Variceal Hemorrhage

Interventions

No use of prophylactic antibioticsOTHER

In the endoscopic secondary prevention of cirrhotic patients with gastroesophageal variceal bleeding, do not use any antibiotics before the endoscopic operation.

Prophylactic AntibioticsDRUG

Intravenous infusion of 2.0g ceftriaxone before endoscopic therapy

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Cirrhotic patients with a history of gastroesophageal variceal bleeding who were readmitted for elective endoscopic treatment. Exclusion Criteria: * (1) Age \< 18 or ≥ 81 years; (2) Allergy to cephalosporin; (3) Agranulocytosis (neutrophil count \< 0.5 × 10\^9/L); (4) Massive ascites; and (5) Signs of bacteria infection. Withdraw Criteria:（1）Transferred to other department for additional treatment after the endoscopic operation (Surgical department for malignant tumor, Interventional radiology department for splenic embolism or transjugular intrahepatic portosystemic shunt, etc.). （2）Lost to follow-up

Locations (1)

The Second Affiliated Hospital of Zhejiang University School of Medicine

Hangzhou, China

Outcomes

Primary Outcomes

Post-operative bacterial infection

Defined as one of the following conditions: (1) Bacteremia: presence of a positive blood culture without definite infectious focus. (2) Spontaneous bacterial peritonitis: Ascitic fluid polymorphonuclear cell count \> 250/mm³ with a positive ascitic culture, or polymorphonuclear cell count \> 500/mm³ when ascitic culture is negative. (3) Pulmonary infection: Confirmed by the presence of pneumonic patches or pleural effusion on pulmonary CT. (4) Urinary tract infection: Abnormal urinary sediment (\>15 leukocytes/ high power field) with a positive urine culture. (5) Possible infection: Unexplained fever \> 37.5°C lasting for more than 6 hours, combined with increased inflammatory index (White blood cell \> 15, 000/mm3, Neutrophil percentage \> 70%, or C-reactive protein \> 10mg/L), but with negative blood cultures.

Time frame: From the date of endoscopic operation (after the endoscopy) until the date of hospital discharge, assessed up to 7 days.

Secondary Outcomes

Three-month rebleeding

Presence of overt hemorrhage, including hematemesis, hematochezia, or melena, due to varices within 3 months following the endoscopic intervention.

Time frame: Within 3 months since the endoscopic operation

Post-operative hospitalization days

Hospital stay (days) after the endoscopic operation

Time frame: From the date of endoscopic operation until the date of hospital discharge, assessed up to 7 days.

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.