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 / Critically appraised article: primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis
Rev. méd. Chile
; 136(10): 1353-1357, Oct. 2008. tab
Article
em Es
|
LILACS-Express
| LILACS
| ID: lil-503907
Biblioteca responsável:
BR1.1
ABSTRACT
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 percent vs 61 percent, P <0.001) and hepatorenal syndrome (28 percent vs 41 percent, P 0.02), and improved the 3-month (94 percent vs 62 percent, P 0.003) and the 1-year (60 percent vs 48 percent, 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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Tipo de estudo:
Clinical_trials
Idioma:
Es
Revista:
Rev. méd. Chile
Assunto da revista:
MEDICINA
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Chile
País de publicação:
Chile