sultamicillin and Gastrointestinal-Hemorrhage

An acute bleeding from oesophageal varices as a result of portal hypertension is a frequent and at the same time serious complication of cirrhosis of the liver. One of factors influencing this bleeding can be a bacterial infection. Endotoxines can increase portal pressure and so participate in development of bleeding and simultaneously deteriorate a patient's prognosis. An antibiotic treatment is a part of a treatment algorithm, however what antibiotics to administer and in what manner is unclear. A group of 46 patients who were admitted to a hospital for an acute bleeding from varices has been compared in the study to 48 cirrhosis patients hospitalised for other reasons. An infection incidence was high in both groups (63.0 % vs. 54.2 %), bleeding patients had more often positive hemoculture (17.3 % vs. 8.6 %), and statistically significantly more often positive findings in throat swab culture (36.9 % vs. 17.3 %, p = 0.04) which is an evidence of an increased pathology colonisation of these patients. Bleeding patients were randomised for peroral norfloxacin administration (n = 25) or an intravenous administration of a combination of ampicilin and sulbactam (n = 21). There was no difference in survival of both groups. Due to a high number of bacterial infections antibiotics administration has been indicated in these patients. Intravenous administration is probably of the same effect as peroral administration.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Ampicillin; Anti-Bacterial Agents; Bacterial Infections; Esophageal and Gastric Varices; Female; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Infusions, Intravenous; Liver Cirrhosis; Male; Middle Aged; Norfloxacin; Sulbactam

We describe nine children with antibiotic-associated hemorrhagic colitis without Clostridium difficile toxin. The onset was usually sudden, with severe hematochezia and abdominal cramps. The illness quickly resolved and required no specific treatment except discontinuation of the implicated antibiotic. Early proctosigmoidoscopy was a useful diagnostic adjunct. It appears that antibiotic-associated hemorrhagic colitis is a distinct entity rather than a variant of antibiotic-associated colitis in children.

Topics: Adolescent; Amoxicillin; Ampicillin; Anti-Bacterial Agents; Cefdinir; Cephalosporins; Child; Child, Preschool; Colitis; Enterocolitis, Pseudomembranous; Female; Gastrointestinal Hemorrhage; Humans; Male; Retrospective Studies; Sulbactam