Real-world efficacy of antibiotic prophylaxis for upper gastrointestinal bleeding in cirrhotic patients in Japan

Background and Aims Antibiotic prophylaxis is recommended for cirrhotic patients with upper gastrointestinal bleeding (UGIB). However, the frequency of bacterial infection in such patients has remarkably decreased over the decades, which has reduced the necessity for prophylaxis. Therefore, here we investigated the real-world adherence and effectiveness of antibiotic prophylaxis in cirrhotic patients with UGIB in Japan. Methods This population-based study was conducted with a Japanese real-world database of the Health, Clinic, and Education Information Evaluation Institute. We enrolled cirrhotic patients who were hospitalized for UGIB between April 2010 and March 2020. After those who died within 24 h and who had aspiration pneumonia at admission were excluded, 1232 patients were analyzed. Rates of 6-week mortality, in-hospital bacterial infection, 30-day readmission, and length of hospital stay were evaluated. Results Prophylactic antibiotics were prescribed in 142 (11.5%) patients. Multivariate analysis revealed that antibiotic prophylaxis was not significantly associated with either 6-week mortality or bacterial infection. After propensity score matching, the rates of 6-week mortality (7.2% vs. 8.4%, P = 0.810), bacterial infection (9.6% vs. 4.2%, P = 0.082), and 30-day unexpected readmission (7.2% vs. 7.8%, P = 1.000) were similar in patients with and without prophylaxis, whereas the median length of hospital stay was significantly longer in patients with prophylaxis (17 days vs. 13 days, P = 0.013). Conclusions Under current real-world circumstances in Japan, prophylactic antibiotics were prescribed in only 11.5% of cirrhotic patients with UGIB and were not associated with better clinical outcomes..

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:58

Enthalten in:

Journal of gastroenterology - 58(2023), 8 vom: 12. Mai, Seite 766-777

Sprache:

Englisch

Beteiligte Personen:

Ueno, Masayuki [VerfasserIn]
Fujiwara, Takashi [VerfasserIn]
Tokumasu, Hironobu [VerfasserIn]
Mano, Toshifumi [VerfasserIn]
Kayahara, Takahisa [VerfasserIn]
Takabatake, Hiroyuki [VerfasserIn]
Morimoto, Youichi [VerfasserIn]
Matsueda, Kazuhiro [VerfasserIn]
Fukuoka, Toshio [VerfasserIn]
Mizuno, Motowo [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

BKL:

44.87$jGastroenterologie

Themen:

Antimicrobial prophylaxis
Liver cirrhosis
Liver failure
Upper gastrointestinal hemorrhage

RVK:

RVK Klassifikation

Anmerkungen:

© Japanese Society of Gastroenterology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s00535-023-02000-y

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2144635374

Zugang & Verfügbarkeit




Zugehörige Publikationen/Bände

    Haven't found what you're looking for?