Tandon et al reviewed infections arising in patients after an episode of acute variceal hemorrhage (AVH). Prophylactic antibiotics can significantly reduce the probability of infection. The authors are from the University of Alberta in Edmonton.
Patient selection: acute variceal hemorrhage (AVH) in an adult with cirrhosis
Duration of prophylaxis: 5-7 days
Infections: all types but bloodstream infection, bacterial peritonitis and urinary tract infections defined
The Child-Pugh score (CPS) was better than the MELD score for defining infectious outcomes.
The benefits of antibiotic prophylaxis were primarily seen in Child-Pugh class B and C (Child-Pugh score >= 7). A Class A patient may not be a suitable candidate for prophylaxis since the rate of infection and death are relatively low.
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