Patients with acute variceal bleeding have a high risk of severe bacterial infection, including spontaneous bacterial peritonitis. They should be treated with short-term prophylactic antibiotics to cover gram-negative organisms whether or not they have ascites. This has been shown not only to decrease bacterial infection but also to improve survival.[38]Tripathi D, Stanley AJ, Hayes PC, et al. UK guidelines on the management of variceal haemorrhage in cirrhotic patients. Gut. 2015 Nov;64(11):1680-704.
https://gut.bmj.com/content/64/11/1680.long
http://www.ncbi.nlm.nih.gov/pubmed/25887380?tool=bestpractice.com
[58]Garcia-Tsao G, Bosch J. Varices and variceal hemorrhage in cirrhosis: a new view of an old problem. Clin Gastroenterol Hepatol. 2015 Nov;13(12):2109-17.
http://www.ncbi.nlm.nih.gov/pubmed/26192141?tool=bestpractice.com
[67]Bernard B, Grangé JD, Khac EN, et al. Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis. Hepatology. 1999 Jun;29(6):1655-61.
http://www.ncbi.nlm.nih.gov/pubmed/10347104?tool=bestpractice.com
[68]Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila FI, et al. Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD002907.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002907.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/20824832?tool=bestpractice.com
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In people with cirrhosis and upper gastrointestinal bleeding, how does antibiotic prophylaxis affect outcomes?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.869/fullShow me the answer
Patients with portal hypertension who develop gastrointestinal bleeding from any etiology, but most commonly from esophageal varices, often develop encephalopathy.
The placement of bands or sclerosing agents often leads to fibrosis in the lower esophagus. In some cases this may lead to narrowing of the esophagus and development of an esophageal stricture.
variable
medium
The risk of bleeding in patients with medium-to-large varices is 15% per year.[4]Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med. 2010 Mar 4;362(9):823-32.
http://www.ncbi.nlm.nih.gov/pubmed/20200386?tool=bestpractice.com