Thai Journal of Gastroenterology

Article :
Norfloxacin 3 Days vs 7 Days in Cirrhotic Patients with Upper Gastrointestinal Hemorrhage : Infection Rate and Mortality, A Preliminary Report

Author :
Ekawee Sripariwuth, M.D.
Duangporn Thong-ngam, M.D.
Rungsun Rerknimitr, M.D.

Abstract :

Background: Bacterial infections are more frequent in cirrhotic patient who admitted with acute gas-
trointestinal hemorrhage compared with others.  The incidences of infection reported in the world literatures were
ranged from 14-67% with an overall incidence of 44%.  The incidence of bacterial infection in cirrhotic patients in
King Chulalongkorn Memorial Hospital was 30 % in 2001, usually occurred during the first three days of hospital-
ization.
Objective: To compare the effectiveness of a three-days course norfloxacin with a seven-days course to
prevent bacterial infection during admission in cirrhotic patients with acute upper gastrointestinal hemorrhage.
Patients and Methods: From October 2002 until December 2003, all cirrhotic patients presented with
acute upper gastrointestinal hemorrhage underwent gastroscopy within 24 hours and treated according to the endo-
scopic findings.  During the first 24 hours of admission, blood, urine and ascitic fluid were sent for culture.  After
that, the patients were randomly allocated into two groups: group 1 received norfloxacin 400 mg twice a day for 3
days, group 2 received norfloxacin 400 mg twice a day for 7 days.  All of them were observed for signs of bacterial
infection during hospitalization and treated appropriately.
Results: Six patients (20.7%) from group 1 and none of the patients from group 2 developed infections.
UTI and bacteremia were proved in two cases.  All of the organisms isolated were gram-negative rods.  The time of
appearance of the infection was in the first three days of hospitalization.  There was no mortality in both groups.
Conclusions: Three-days course norfloxacin 400 mg twice a day may be sufficient for prevention of
bacterial infection in cirrhotic patients with acute upper gastrointestinal hemorrhage.

[Thai J Gastroenterol 2004; 5(2): 82-86]

Keyword :
Norfloxacin, cirrhotic, upper gastrointestinal hemorrhage

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