Abstract:
Introduction: There was a suggestion that administration of norfloxacin 800 mg daily for at least 7 days can prevent bacterial infection in cirrhotic patients with upper gastrointestinal hemorrhage. However, the 3- days duration may be sufficient since the bacterial infection usually occurred during the first three days of hospitalization. Aim: To compare the effectiveness of a three-day course norfloxacin with a seven-day course to prevent bacterial infection during admission in cirrhotic patients with acute upper gastrointestinal hemorrhage. Patients and Methods : From October 2002 until December 2003, cirrhotic patients with upper gastrointestinal hemorrhage underwent gastroscopy and phlebotomy for blood culture. Urine and ascites were also sent for culture within 24 hours. Then, they received norfloxacin 800 mg daily for 3 days and were observed for signs of bacterial infection during hospitalization. The control group was cirrhotic patients with upper gastrointestinal hemorrhage in 2001 who did not receive norfloxacin. Results: There were no significant difference between both groups on clinical and laboratory data of the patients during admission and hospitalization except creatinine level, direct bilirubin, prothrombin time and amount of pack red cell transfusion. The infection rate in patients who received norfloxacin was 18% compared to 30% in historical control group. All of the infections occurred during the first three days of hospitalization. Conclusion: Norfloxacin 800 mg daily for 3 days may be sufficient for prevention of bacterial infection in cirrhotic patients with acute upper gastrointestinal hemorrhage.