Evaluating the Clinical Endpoint of Antibiotic Prophylaxis for Cirrhosis Patients Complicated with Upper Gastrointestinal Bleeding: An Updated Systematic Review and Meta-analysis

Authors

  • Putu Itta Sandi Lesmana Dewi, MD Centre Research for Alimentary and Hepatobiliary System, Bali, Indonesia https://orcid.org/0000-0001-5426-9513
  • Kadek Mercu Narapati Pamungkas, MD Centre Research for Alimentary and Hepatobiliary System, Bali, Indonesia https://orcid.org/0009-0001-0418-2652
  • Ni Luh Putu Yunia Dewi, MD Centre Research for Alimentary and Hepatobiliary System, Bali, Indonesia https://orcid.org/0000-0003-4164-426X
  • Ni Nyoman Gita Kharisma Dewi, MD Centre Research for Alimentary and Hepatobiliary System, Bali, Indonesia https://orcid.org/0000-0002-1630-5605
  • Dwijo Anargha Sindhughosa, MD Centre Research for Alimentary and Hepatobiliary System, Bali, Indonesia; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine Udayana University - Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia https://orcid.org/0000-0001-9665-8082
  • I Ketut Mariadi, MD, PhD Centre Research for Alimentary and Hepatobiliary System, Bali, Indonesia; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine Udayana University - Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia https://orcid.org/0000-0001-9665-8082

DOI:

https://doi.org/10.47895/amp.vi0.10174

Keywords:

antibiotic, prophylaxis, cirrhosis, variceal bleeding

Abstract

Background and Objective. Antibiotic prophylaxis is used to prevent bacterial infections and rebleeding in cirrhosis patients with upper gastrointestinal bleeding (UGIB). However, the effects of various antibiotics on patients with UGIB are still being considered. This study aims to evaluate the effect of antibiotic prophylaxis on cirrhosis patients with UGIB.

Methods. The studies were searched through databases of PubMed, ScienceDirect, Wiley Online Library, and CENTRAL from 2013 to 2023. We used Revman 5.4 to perform a meta-analysis. I2 statistics measured the heterogeneity test. The odds ratio (OR) and 95% confidence interval (CI) were used to assess the effect of antibiotic prophylaxis.

Results. Twelve studies involving 14,825 cirrhosis patients were included in this study. Based on the meta-analysis, antibiotic prophylaxis significantly lowered the bacterial infection rate (OR: 0.29, 95%CI: 0.10 to 0.84, P = 0.02), and the incidence of serious adverse events (SAE) (OR: 0.50, 95%CI: 0.28 to 0.88, P = 0.02) in cirrhosis patients with UGIB.

Conclusions. Administration of antibiotics demonstrated a significant reduction in bacterial infection rates and SAEs. Broad-spectrum non-absorbable antibiotics can be used in cirrhosis patients with UGIB. The appropriate use of antibiotics is important to prevent resistance.

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Published

2024-09-18

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How to Cite

1.
Evaluating the Clinical Endpoint of Antibiotic Prophylaxis for Cirrhosis Patients Complicated with Upper Gastrointestinal Bleeding: An Updated Systematic Review and Meta-analysis. Acta Med Philipp [Internet]. 2024 Sep. 18 [cited 2025 Apr. 3];. Available from: https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/10174