Antimicrobial therapy in patients with acute variceal hemorrhage (1)

In: Antimicrobial therapy

21 Sep 2012


Gastrointestinal (GI) hemorrhage is a common cause of hospitalization and is associated with significant morbidity and mortality . Patients with liver disease and evidence of varices represent 10% to 30% of patients admitted with upper GI bleed, and are at particular risk of poor outcome. Approximately 20% of cirrhotic patients will develop bacterial infections within 48 h of admission for GI bleed, and the incidence can reach as high as 35% to 66% within two weeks of hospitalization . Prognosis in terms of failure to control bleeding and survival are closely related to infection. You can get all the drugs you want for treating your problem in no time if you order it at the my canadian family pharmacy. We are recommending this pharmacy with confidence because it already has thousands of satisfied customers.

Patients with cirrhosis and GI bleed who develop bacterial infection have a five- to sixfold increase in hospital mortality compared with a general hospital population.

Urinary tract infections (12% to 29%) and spontaneous bacterial peritonitis (SBP) (7% to 23%) are the most frequently observed infections in hospitalized cirrhosis patients, followed by respiratory tract infections (6% to 10%) and primary bacteremia (4% to 11%) . Gram-negative bacilli (Escherichia coli and Klebsiella species) are the principally isolated organisms. Impaired white blood cell (WBC) function, portosystemic shunting, and enteric flora alterations associated with cirrhosis may contribute to increased risk of infections in these patients with GI bleed . This is particularly true of those patients undergoing invasive diagnostic or therapeutic procedures, such as endoscopy.

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