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  1. Parenteral antibiotic prophylaxis of bacterial infections does not improve cost-efficacy of oral norfloxacin in cirrhotic patients with gastrointestinal bleeding.

    Article - En anglais

    Objective 

    Selective intestinal decontamination with norfloxacin is useful in the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding.

    However, bleeding cirrhotic patients with ascites, encephalopathy, or shock are at high risk to develop bacterial infections in spite of prophylactic norfloxacin.

    The aim of this study was to assess whether the addition of intravenous ceftriaxone could improve the efficacy of prophylaxis with norfloxacin in these patients.

    Methods 

    Fifty-six cirrhotic patients with gastrointestinal hemorrhage and ascites, encephalopathy, or shock were randomized into two groups : Group 1 (n=28) received oral norfloxacin 400 mg/12 h for 7 days, and group 2 (n=28) received norfloxacin plus intravenous ceftriaxone 2 g daily during the first 3 days of admission.

    Results 

    Ten patients were excluded because of community-acquired infection, surgery, or death within the first 24 h. The incidence of bacterial infections during hospitalization was 18.1% in group 1 and 12.5% in group 2 (p=NS).

    The incidence of severe infections (spontaneous bacterial peritonitis, bacteremia, or pneumonia) was also similar in both groups : 9% in group 1 versus 8.3% in group 2 (p=NS).

    There were no statistical differences between the two groups with respect to duration of hospitalization or mortality.

    The cost of antibiotic therapy (including prophylaxis and treatment of infections) was significantly higher in group 2. (...)

    Mots-clés Pascal : Cirrhose, Foie, Complication, Hémorragie, Gastrointestinal, Chimiothérapie, Norfloxacine, Antibactérien, Effet biologique, Association médicamenteuse, Chimioprophylaxie, Bactériose, Infection, Efficacité traitement, Analyse avantage coût, Homme, Fluoroquinolone dérivé, Quinolone dérivé, Appareil digestif pathologie, Foie pathologie, Estomac pathologie, Intestin pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Economie santé

    Mots-clés Pascal anglais : Cirrhosis, Liver, Complication, Hemorrhage, Gastrointestinal, Chemotherapy, Norfloxacin, Antibacterial agent, Biological effect, Drug combination, Chemoprophylaxis, Bacteriosis, Infection, Treatment efficiency, Cost benefit analysis, Human, Fluoroquinolone derivatives, Quinolone derivatives, Digestive diseases, Hepatic disease, Gastric disease, Intestinal disease, Cardiovascular disease, Vascular disease, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0063356

    Code Inist : 002B02S02. Création : 31/05/1999.