Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Delayed and inappropriate antimicrobial therapy increases mortality in cirrhosis

This month's issue of Hepatology identifies antimicrobial therapeutic determinants of septic shock in cirrhosis.

News image

It is unclear whether practice-related aspects of antimicrobial therapy contribute to the high mortality from septic shock among patients with cirrhosis.

Dr Yaseen Arabi and colleagues from Saudi Arabia examined the relationship between aspects of initial empiric antimicrobial therapy and mortality in patients with cirrhosis and septic shock.

The team performed a nested cohort study within a large retrospective database of septic shock from 28 medical centers in Canada, the United States, and Saudi Arabia by the Cooperative Antimicrobial Therapy of Septic Shock Database Research Group between 1996 and 2008.

The team examined the impact of initial empiric antimicrobial therapeutic variables on the hospital mortality of patients with cirrhosis and septic shock.

Hospital mortality was 76%
Hepatology

Among 635 patients with cirrhosis and septic shock, the hospital mortality was 76%.

Inappropriate initial empiric antimicrobial therapy was administered in 24% of patients.

The median time to appropriate antimicrobial administration was 7 hours.

The use of inappropriate initial antimicrobials was associated with increased mortality, as was the delay in appropriate antimicrobials.

The research team found that among patients with eligible bacterial septic shock, a single rather than 2 or more appropriate antimicrobials was used in 73% of patients, and was also associated with higher mortality.

The team observed that these findings were consistent across various clinically relevant subgroups.
 
Dr Arabi's team concludes, "In patients with cirrhosis and septic shock, inappropriate and delayed appropriate initial empiric antimicrobial therapy is associated with increased mortality."

"Monotherapy of bacterial septic shock is also associated with increased mortality."

Hepatology 2012: 56(6): 2305–2315
24 December 2012

Go to top of page Email this page Email this page to a colleague

 20 April 2014

Advanced search
 18 April 2014 
GastroHep.com Easter break
 17 April 2014 
Diabetes mellitus and acute pancreatitis
 17 April 2014 
Screening for low bone mineral density among ulcerative colitis
 17 April 2014 
Bowel cleansing for colonoscopy
 16 April 2014 
Evaluating pharmacologic agents in IBS
 16 April 2014 
Isotretinoin and IBD risk
 16 April 2014 
Mortality in bleeding Mallory-Weiss syndrome vs peptic ulcer bleeding
 15 April 2014 
Dietary fat and risk of IBD
 15 April 2014 
Quality of life in microscopic colitis
 15 April 2014 
New prognostic score for cirrhosis
 14 April 2014 
Changing liver cancer mortality rates in the United States
 14 April 2014 
Inflammatory sacroiliitis by MRI in IBD
 14 April 2014 

5-aminosalicylates in early pregnancy and congenital malformation risk

 11 April 2014 
H pylori resistance to antibiotics
 11 April 2014 
Predictors of corticosteroid treatment outcomes for ulcerative colitis
 11 April 2014 
Antibiotic combination therapy for ulcerative colitis
 10 April 2014 
Mortality in Crohn's disease
 10 April 2014 
Prophylaxis against venous thromboembolism in hospitalized ulcerative colitis
 10 April 2014 
Probiotic treatment and infant colic
 09 April 2014 
Preventing death in general intensive care
 09 April 2014 
Neoplasm risk after polypectomy
 09 April 2014 
Disclosure program and gastroenterology-related claims
 08 April 2014 

Regurgitation and health-related quality of life in GERD

 08 April 2014 
H. pylori resistance to antibiotics
 08 April 2014 
Management of chronic diarrhea
 07 April 2014 
Meat intake and liver cancer
 07 April 2014 
Gastrointestinal angiodysplastic lesions
 07 April 2014 
Adenoma detection and colorectal cancer risk
 04 April 2014 
Stool DNA tests for colorectal cancer
 04 April 2014 
PET-CT predicts outcome in colorectal liver metastases
 04 April 2014 

Prophylaxis of post-ERCP pancreatitis

 03 April 2014 
Management of esophageal or gastric variceal bleeding
 03 April 2014 
Exclusionary diets for IBD
 03 April 2014 
Mortality with chronic pancreatitis
 02 April 2014 
Disease course of early-onset pediatric IBD
 02 April 2014 
Risk of liver fibrosis progression in chronic hep B
 02 April 2014 
Colorectal cancer and patient survival
 01 April 2014 
Outcomes in patients with Hep C
 01 April 2014 
Diagnosis of functional dyspepsia
 01 April 2014 
Genetic risk factors for stenosis and infections in primary sclerosing cholangitis
 31 March 2014 
Diet-gene interactions and Crohn's
 31 March 2014 
Transjugular intrahepatic portosystemic stent-shunts in Budd–Chiari syndrome
 31 March 2014 
Hepatic decompensation in antiretroviral-treated patients
 28 March 2014 
Glucocorticoids and mortality after colorectal cancer surgery
 28 March 2014 
Long-term metformin use and gastric cancer risk
 28 March 2014 
Distance from a liver transplant center and survival
 27 March 2014 
Radiofrequency ablation vs endoscopy for Barrett's
 27 March 2014 
Omega-3 fatty acid and Crohn's disease
 27 March 2014 
Thromboembolism prophylaxis in IBD
 26 March 2014 
Disparities in evaluation of rectal bleeding
 26 March 2014 
Prediction of H. pylori status after endoscopy
 26 March 2014 
Fatigue and depression in IBD
 25 March 2014 
Depression risk in IBD
 25 March 2014 
Fecal incontinence in the USA
 25 March 2014 
Circulating gastrin and colorectal carcinoma risk
 24 March 2014 
Parental-rearing styles in IBS
 24 March 2014 
Endocannabinoid system in liver disease
 24 March 2014 
Maternal iron supplementation during pregnancy
 21 March 2014 
Eosinophilic esophagitis in the United States
 21 March 2014 
Chemoradiotherapy for anal cancer in HIV patients

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us