Antimicrobial therapy in patients with acute variceal hemorrhage: METHODS

In: Antimicrobial therapy

23 Sep 2012

A retrospective chart review was conducted at a major tertiary care centre in Canada. Patients admitted to hospital with suspected variceal hemorrhage during a 33-month period between January 2001 and September 2003 were evaluated for inclusion. The study received university and hospital ethics approval before initiation.

Patients with liver disease were included if they had evidence of bleeding varices by upper endoscopy performed at hospital admission. Cirrhosis patients admitted and found to have bleeding from other GI sources were also reviewed. Data were collected pertaining to the etiology of liver disease, history or current physical findings of ascites, hepatic encephalopathy and SBP, as well as admission vital signs and laboratory values, including blood pressure (BP), heart rate (HR), temperature, hemoglobin, WBC, platelets, urea, serum creatinine, albumin, international normalized ratio, total and direct bilirubin, aspartate aminotransferase and alanine aminotransferase. Management strategies for the presenting hemorrhage and length of stay were recorded. The Child-Pugh and model for end-stage liver disease (MELD) scores were also calculated. You will always find actos buy, shopping online with pleasure every time.

Information pertaining to possible infection was collected for all patients, including culture and susceptibility studies of any blood, urine, ascitic fluid or sputum samples performed and types of organisms isolated. Those patients who received antibiotic therapy during hospitalization were identified; time-to-medication initiation was recorded, specifically, in those prescribed antimicrobial therapy within 24 h of admission and subsequent endoscopy. Selection of specific agents was documented.

The x2 test was used for comparisons between qualitative variables, and Student’s t test was used for comparisons between quantitative variables expressed as mean ± SD. Multivariate analysis techniques (SPSS 11.0 for Windows, SPSS Inc, USA) were performed to determine if any factors were associated with antimicrobial use.

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