Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis
Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis. A post hoc analysis...
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| Veröffentlicht in: | Journal of hepatology Jg. 75; H. 2; S. 342 - 350 |
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| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
Netherlands
Elsevier B.V
01.08.2021
Elsevier Science Ltd Elsevier |
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| ISSN: | 0168-8278, 1600-0641, 1600-0641 |
| Online-Zugang: | Volltext |
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| Abstract | Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis.
A post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization.
A total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9).
Bacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.
Bacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.
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•Bacterial infections still occur in around one-fifth of patients with cirrhosis and acute variceal bleeding despite antibiotic prophylaxis.•Respiratory bacterial infections are the most frequent, occurring early after admission.•Respiratory infections are related to the severity of cirrhosis, presence of severe hepatic encephalopathy and airway manipulation.•Over 50% of the bacteria isolated in this series were resistant to third-generation cephalosporines. |
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| AbstractList | Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis.
A post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization.
A total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9).
Bacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.
Bacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis.BACKGROUND & AIMSAntibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis.A post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization.METHODSA post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization.A total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9).RESULTSA total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9).Bacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.CONCLUSIONBacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.Bacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.LAY SUMMARYBacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis. A post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization. A total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9). Bacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. Bacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. [Display omitted] •Bacterial infections still occur in around one-fifth of patients with cirrhosis and acute variceal bleeding despite antibiotic prophylaxis.•Respiratory bacterial infections are the most frequent, occurring early after admission.•Respiratory infections are related to the severity of cirrhosis, presence of severe hepatic encephalopathy and airway manipulation.•Over 50% of the bacteria isolated in this series were resistant to third-generation cephalosporines. Background & Aims Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis. Methods A post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization. Results A total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9). Conclusion Bacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. Lay summary Bacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. |
| Author | Primignani, Massimo Calleja, Jose Luis Cañete, Nuria Castellote, Jose Téllez, Luis Hernández-Guerra, Manuel Mundi, Jose Luis Nevens, Frederik García-Pagán, Juan Carlos Casas, Meritxell Robic, Marie Angèle Albillos, Agustín Masnou, Helena Silva-Junior, Gilberto Trebicka, Jonel Alvarado, Edilmar Rudler, Marika Schwarzer, Remy Ibañez-Samaniego, Luis Amitrano, Lucio Genescà, Joan Krag, Aleksander Jansen, Christian Martínez, Javier Palazon, Jose María Bañares, Rafael Abraldes, Juan G. Ferlitsch, Arnulf Villanueva, Candid Bureau, Christophe Laleman, Wim Conejo, Irene Hernández-Gea, Virginia Thabut, Dominique Senzolo, Marco Gluud, Lise L. Zipprich, Alexander Catalina, Maria Vega Rodrigues, Susana Gronbaek, Henning Procopet, Bogdan Rodríguez-de-Santiago, Enrique Dell'Era, Alessandra Rodríguez, Manuel Sassatelli, Romano Noronha-Ferreira, Carlos Romero-Gomez, Manuel Fischer, Petra Bosch, Jaime Llop, Elba Giráldez, Álvaro Perez-Campuzano, Valeria Guardascione, Maria Anna |
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Division of Liver and Biliopancreatic Disorders, University Hospitals Leuven – KU Leuven, Leuven, Belgium – sequence: 19 givenname: Jose María surname: Palazon fullname: Palazon, Jose María organization: Hospital General Universitario de Alicante, Alicante, Spain – sequence: 20 givenname: Jose orcidid: 0000-0002-8528-3112 surname: Castellote fullname: Castellote, Jose organization: Gastroenterology Department, Hepatology Unit, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain – sequence: 21 givenname: Susana surname: Rodrigues fullname: Rodrigues, Susana organization: Gastroenterology and Hepatology Department, Centro Hospitalar São João, Porto, Portugal – sequence: 22 givenname: Lise L. surname: Gluud fullname: Gluud, Lise L. organization: Gastro Unit, Medical Division, University Hospital of Hvidovre, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark – sequence: 23 givenname: Carlos surname: Noronha-Ferreira fullname: Noronha-Ferreira, Carlos organization: Serviço de Gastroenterología e Hepatologia, Hospital de Santa Maria – Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal – sequence: 24 givenname: Nuria surname: Cañete fullname: Cañete, Nuria organization: Liver Section, Gastroenterology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain – sequence: 25 givenname: Manuel surname: Rodríguez fullname: Rodríguez, Manuel organization: Department of Gastroenterology, Hospital Central de Asturias, Oviedo, Spain – sequence: 26 givenname: Arnulf surname: Ferlitsch fullname: Ferlitsch, Arnulf organization: Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria – sequence: 27 givenname: Remy surname: Schwarzer fullname: Schwarzer, Remy organization: Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria – sequence: 28 givenname: Jose Luis surname: Mundi fullname: Mundi, Jose Luis organization: Department of Gastroenterology, University Hospital San Cecilio, Granada, Spain – sequence: 29 givenname: Henning orcidid: 0000-0001-8998-7910 surname: Gronbaek fullname: Gronbaek, Henning organization: Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark – sequence: 30 givenname: Manuel surname: Hernández-Guerra fullname: Hernández-Guerra, Manuel organization: Gastroenterology Department, University Hospital of the Canary Islands, La Laguna, Tenerife, Spain – sequence: 31 givenname: Romano surname: Sassatelli fullname: Sassatelli, Romano organization: Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy – sequence: 32 givenname: Alessandra surname: Dell'Era fullname: Dell'Era, Alessandra organization: Gastroenterology Unit, ASST Fatebenefratelli Sacco, Department of Clinical and Biomedical Sciences 'Luigi Sacco', University of Milan, Milan, Italy – sequence: 33 givenname: Marco surname: Senzolo fullname: Senzolo, Marco organization: Multivisceral Transplant Unit, Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy – sequence: 34 givenname: Juan G. surname: Abraldes fullname: Abraldes, Juan G. organization: Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada – sequence: 35 givenname: Manuel orcidid: 0000-0001-8494-8947 surname: Romero-Gomez fullname: Romero-Gomez, Manuel organization: Unidad de Hepatología, Hospital Universitario de Valme, CIBERehd, Sevilla, Spain – sequence: 36 givenname: Alexander orcidid: 0000-0001-8403-7983 surname: Zipprich fullname: Zipprich, Alexander organization: First Department of Internal Medicine, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany – sequence: 37 givenname: Meritxell surname: Casas fullname: Casas, Meritxell organization: Hepatology Unit, Digestive Disease Department Hospital de Sabadell, Universitat Autónoma de Barcelona, Sabadell, Spain – sequence: 38 givenname: Helena orcidid: 0000-0003-0632-1393 surname: Masnou fullname: Masnou, Helena organization: Hospital Universitari Germans Trias i Pujol, Universitat Autònoma Barcelona, Badalona, Spain – sequence: 39 givenname: Massimo orcidid: 0000-0003-1588-2643 surname: Primignani fullname: Primignani, Massimo organization: Division of Gastroenterology and Hepatology, IRCCSCa’Granda Maggiore Hospital Foundation, University of Milan, Milan, Italy – sequence: 40 givenname: Frederik surname: Nevens fullname: Nevens, Frederik organization: Department Gastroenterology and Hepatology. Division of Liver and Biliopancreatic Disorders, University Hospitals Leuven – KU Leuven, Leuven, Belgium – sequence: 41 givenname: Jose Luis surname: Calleja fullname: Calleja, Jose Luis organization: Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain – sequence: 42 givenname: Christian surname: Jansen fullname: Jansen, Christian organization: Department of Internal Medicine I, Universitiy of Bonn, Bonn, Germany – sequence: 43 givenname: Marie Angèle surname: Robic fullname: Robic, Marie Angèle organization: Department of Hepato-Gastroenterology, Purpan Hospital, CHU Toulouse, INSERM U858, University of Toulouse, Toulouse, France – sequence: 44 givenname: Irene surname: Conejo fullname: Conejo, Irene organization: Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain – sequence: 45 givenname: Maria Vega surname: Catalina fullname: Catalina, Maria Vega organization: Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain – sequence: 46 givenname: Marika surname: Rudler fullname: Rudler, Marika organization: Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain – sequence: 47 givenname: Edilmar orcidid: 0000-0003-2036-6133 surname: Alvarado fullname: Alvarado, Edilmar organization: Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain – sequence: 48 givenname: Valeria orcidid: 0000-0002-5997-9511 surname: Perez-Campuzano fullname: Perez-Campuzano, Valeria organization: Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain – sequence: 49 givenname: Maria Anna surname: Guardascione fullname: Guardascione, Maria Anna organization: Gastroenterology Unit, Ospedale A Cardarelli, Naples, Italy – sequence: 50 givenname: Petra surname: Fischer fullname: Fischer, Petra organization: Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, Hepatology Department and “Iuliu Hatieganu” University of Medicine and Pharmacy, 3rd Medical Clinic, Cluj-Napoca, Romania – sequence: 51 givenname: Jaime surname: Bosch fullname: Bosch, Jaime organization: Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain – sequence: 52 givenname: Juan Carlos surname: García-Pagán fullname: García-Pagán, Juan Carlos organization: Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain – sequence: 53 givenname: Agustín orcidid: 0000-0001-9131-2592 surname: Albillos fullname: Albillos, Agustín email: agustin.albillos@uah.es organization: Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Universidad de Alcalá, Madrid, Spain |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33845059$$D View this record in MEDLINE/PubMed https://hal.science/hal-04868301$$DView record in HAL |
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| Copyright | 2021 European Association for the Study of the Liver Copyright © 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. Copyright Elsevier Science Ltd. Aug 2021 Distributed under a Creative Commons Attribution 4.0 International License |
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| Keywords | Antibiotic prophylaxis Bacterial infection Cirrhosis Acute variceal bleeding Respiratory infection |
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| SubjectTerms | Acute variceal bleeding Aged Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Antibiotic prophylaxis Antibiotic Prophylaxis - methods Antibiotic Prophylaxis - standards Antibiotic Prophylaxis - statistics & numerical data Antibiotics Bacteria Bacterial infection Bacterial infections Bacterial Infections - drug therapy Bacterial Infections - epidemiology Bacterial Infections - etiology Balloon treatment Bleeding Cephalosporins Cephalosporins - pharmacology Cephalosporins - therapeutic use Cirrhosis Disease prevention Endoscopy Esophageal and Gastric Varices - complications Esophageal and Gastric Varices - epidemiology Esophagus Female Hemorrhage - epidemiology Hemorrhage - etiology Hepatic encephalopathy Hospitalization Humans Incidence Infections Intubation Life Sciences Liver cirrhosis Liver diseases Logistic Models Male Middle Aged Multivariate Analysis Odds Ratio Prophylaxis Quinolones Quinolones - pharmacology Quinolones - therapeutic use Respiratory infection Risk Factors Shunts Tamponade Tomography |
| Title | Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis |
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