Análisis crítico de un artículo: La profilaxis primaria de peritonitis bacteriana espontánea disminuye la aparición de síndrome hepatorrenal y mejora la sobrevida en pacientes cirróticos avanzados
Background & Aims: Norfloxacin is highly effective in preventing spontaneous bacterial peritonitis recurrence in cirrhosis, but its role in the primary prevention of this complication is uncertain. Methods: Patients with cirrhosis and low protein ascitic levéis (<15 g/L) with advanced...
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Sociedad Médica de Santiago
2008
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oai:scielo:S0034-988720080010000192009-01-15Análisis crítico de un artículo: La profilaxis primaria de peritonitis bacteriana espontánea disminuye la aparición de síndrome hepatorrenal y mejora la sobrevida en pacientes cirróticos avanzadosRoa S,MacarenaRada G,GabrielBackground & Aims: Norfloxacin is highly effective in preventing spontaneous bacterial peritonitis recurrence in cirrhosis, but its role in the primary prevention of this complication is uncertain. Methods: Patients with cirrhosis and low protein ascitic levéis (<15 g/L) with advanced liver failure (Child-Pugh score >9 points with serum bilirubin level >3 mg/dL) or impaired renal function (serum creatinine level >1.2 mg/dL, blood urea nitrogen level >25 mg/dL, or serum sodium level <130 mEq/L) were included in a randomized controlled trial aimed at comparing norfloxacin (35 patients) vs placebo (33 patients) in the primary prophylaxis of spontaneous bacterial peritonitis. The main end points of the trial were 3-month and 1-year probability of survival. Secondary end points were 1-year probability of development of spontaneous bacterial peritonitis and hepatorenal syndrome. Results: Norfloxacin administration reduced the 1-year probability of developing spontaneous bacterial peritonitis (7% vs 61%, P <0.001) and hepatorenal syndrome (28% vs 41%, P 0.02), and improved the 3-month (94% vs 62%, P 0.003) and the 1-year (60% vs 48%, P 0.05) probability of survival compared with placebo. Conclusions: Primary prophylaxis with norfloxacin has a great impact in the clinical course of patients with advanced cirrhosis. It reduces the incidence of spontaneous bacterial peritonitis, delays the development of hepatorenal syndrome, and improves survival.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.136 n.10 20082008-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001000019es10.4067/S0034-98872008001000019 |
| institution |
Scielo Chile |
| collection |
Scielo Chile |
| language |
Spanish / Castilian |
| description |
Background & Aims: Norfloxacin is highly effective in preventing spontaneous bacterial peritonitis recurrence in cirrhosis, but its role in the primary prevention of this complication is uncertain. Methods: Patients with cirrhosis and low protein ascitic levéis (<15 g/L) with advanced liver failure (Child-Pugh score >9 points with serum bilirubin level >3 mg/dL) or impaired renal function (serum creatinine level >1.2 mg/dL, blood urea nitrogen level >25 mg/dL, or serum sodium level <130 mEq/L) were included in a randomized controlled trial aimed at comparing norfloxacin (35 patients) vs placebo (33 patients) in the primary prophylaxis of spontaneous bacterial peritonitis. The main end points of the trial were 3-month and 1-year probability of survival. Secondary end points were 1-year probability of development of spontaneous bacterial peritonitis and hepatorenal syndrome. Results: Norfloxacin administration reduced the 1-year probability of developing spontaneous bacterial peritonitis (7% vs 61%, P <0.001) and hepatorenal syndrome (28% vs 41%, P 0.02), and improved the 3-month (94% vs 62%, P 0.003) and the 1-year (60% vs 48%, P 0.05) probability of survival compared with placebo. Conclusions: Primary prophylaxis with norfloxacin has a great impact in the clinical course of patients with advanced cirrhosis. It reduces the incidence of spontaneous bacterial peritonitis, delays the development of hepatorenal syndrome, and improves survival. |
| author |
Roa S,Macarena Rada G,Gabriel |
| spellingShingle |
Roa S,Macarena Rada G,Gabriel Análisis crítico de un artículo: La profilaxis primaria de peritonitis bacteriana espontánea disminuye la aparición de síndrome hepatorrenal y mejora la sobrevida en pacientes cirróticos avanzados |
| author_facet |
Roa S,Macarena Rada G,Gabriel |
| author_sort |
Roa S,Macarena |
| title |
Análisis crítico de un artículo: La profilaxis primaria de peritonitis bacteriana espontánea disminuye la aparición de síndrome hepatorrenal y mejora la sobrevida en pacientes cirróticos avanzados |
| title_short |
Análisis crítico de un artículo: La profilaxis primaria de peritonitis bacteriana espontánea disminuye la aparición de síndrome hepatorrenal y mejora la sobrevida en pacientes cirróticos avanzados |
| title_full |
Análisis crítico de un artículo: La profilaxis primaria de peritonitis bacteriana espontánea disminuye la aparición de síndrome hepatorrenal y mejora la sobrevida en pacientes cirróticos avanzados |
| title_fullStr |
Análisis crítico de un artículo: La profilaxis primaria de peritonitis bacteriana espontánea disminuye la aparición de síndrome hepatorrenal y mejora la sobrevida en pacientes cirróticos avanzados |
| title_full_unstemmed |
Análisis crítico de un artículo: La profilaxis primaria de peritonitis bacteriana espontánea disminuye la aparición de síndrome hepatorrenal y mejora la sobrevida en pacientes cirróticos avanzados |
| title_sort |
análisis crítico de un artículo: la profilaxis primaria de peritonitis bacteriana espontánea disminuye la aparición de síndrome hepatorrenal y mejora la sobrevida en pacientes cirróticos avanzados |
| publisher |
Sociedad Médica de Santiago |
| publishDate |
2008 |
| url |
http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001000019 |
| work_keys_str_mv |
AT roasmacarena analisiscriticodeunarticulolaprofilaxisprimariadeperitonitisbacterianaespontaneadisminuyelaapariciondesindromehepatorrenalymejoralasobrevidaenpacientescirroticosavanzados AT radaggabriel analisiscriticodeunarticulolaprofilaxisprimariadeperitonitisbacterianaespontaneadisminuyelaapariciondesindromehepatorrenalymejoralasobrevidaenpacientescirroticosavanzados |
| _version_ |
1718436409882181632 |