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

Shou-Wu Lee^1,2*, Teng-Yu Lee^1,2, Sheng-Shun Yang^1,3, Chung-Wang Ko^1,3, Hong-Zen Yeh^1,3, Chi-Sen Chang^1,2

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Chinese Taipei.
²Department of Internal Medicine, Chung Shan Medical University, Taichung, Chinese Taipei.
³Department of Internal Medicine, Yang-Ming University School of Medicine, Taipei, Chinese Taipei.

DOI: 10.4236/ojgas.2013.33030                

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 mortality within 10 days after initial bleeding. 

Keywords

Cirrhosis; Esophageal Variceal Hemorrhage; Mortality; Rebleeding

Conflicts of Interest

The authors declare no conflicts of interest.

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