The impact of intravenous cefazolin to the outcomes of cirrhotic patients with esophageal varices bleeding

Abstract

Background and Method: Prophylatic antibiotics in cirrhotic patients with acute esophageal varices (EV) bleeding has been shown to increase survival and decrease the rate of bacterial infections and recurrent bleeding. This study aimed to compare the outcome of intravenous cefazolin, a first-generation cephalosporin, in the cirrhotic patients with EV bleeding. 92 consecutive cirrhotic patients with EV bleeding but without evidence of infection were retrospectively analyzed from December 2006 to February 2009, and 50 with cefazolin prophylaxis and 42 without antibiotic prophylaxis were enrolled in the antibiotic prophylaxis group and control group respectively. The outcomes were compared between both groups. Results: The incidence of infection was significantly lesser in the antibiotic prophylaxis group than that of the control group (6% vs. 33.3%, P < 0.05). The incidence of recurrent EV bleeding (6% vs. 9.5%) and mortality (4% vs. 7.1%) showed no significant difference between both groups. Mean length of hospital stay was shorter, but insignificant in the antibiotic prophylaxis group when compared with control group (6.6 vs. 7.8 days). Conclusion: Intravenous cefazolin can effectively reduce the rate of infection in cirrhotic patients with acute EV bleeding, but cannot significant benefit for preventing recurrent EV bleeding and mor tality within 10 days after initial bleeding.