Oral antibiotic prophylaxis improves survival in cirrhosis

Antibiotic prophylaxis should be considered for all high-risk cirrhotic patients with ascites, a meta-analysis concludes. While studies assessing the use of oral antibiotics in advanced liver disease demonstrate a clear benefit in reducing the risk of recurrent peritonitis, it is unclear whether mortality rates are similarly affected by this practice, the researchers wrote in the American Journal of Gastroenterology. Their search of the Cochrane Database and MEDLINE between 1966 to 2008 identified 8 studies with a total of 647 patients. The research team found that the overall mortality rate was 16% for treated patients, and 25% for the control group. Groups treated with prophylactic antibiotics also demonstrated a lower incidence of all infections of 6% as compared with the control groups with a rate of 22%. Subgroup analysis showed a survival benefit at three months. “Antibiotic prophylaxis improved short-term survival in treated patients when compared with untreated control groups and reduced the overall risk of infections, including spontaneous bacterial peritonitis, during follow-up,” the research team concluded....