Cirrhosis, Liver Hypertension, Portal Variceal Hemorrhage
Conditions
Brief summary
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.
Interventions
In the endoscopic secondary prevention of cirrhotic patients with gastroesophageal variceal bleeding, do not use any antibiotics before the endoscopic operation.
Intravenous infusion of 2.0g ceftriaxone before endoscopic therapy
Sponsors
Second Affiliated Hospital, School of Medicine, Zhejiang University
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post-operative bacterial infection | From the date of endoscopic operation (after the endoscopy) until the date of hospital discharge, assessed up to 7 days. | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Three-month rebleeding | Within 3 months since the endoscopic operation | Presence of overt hemorrhage, including hematemesis, hematochezia, or melena, due to varices within 3 months following the endoscopic intervention. |
| Post-operative hospitalization days | From the date of endoscopic operation until the date of hospital discharge, assessed up to 7 days. | Hospital stay (days) after the endoscopic operation |
Countries
China
Outcome results
None listed