Prophylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis

Are shorter durations (including 0 days) noninferior to longer durations of antibiotic prophylaxis for upper gastrointestinal bleeding in patients with cirrhosis?This systematic review and meta-analysis of 14 randomized clinical trials including 1322 participants found that the studies were of low to moderate quality and their results indicated a high probability that shorter antibiotic prophylaxis durations (including 0 days) were noninferior to longer durations for all-cause mortality, but not for early rebleed or bacterial infections.These findings suggest that guideline recommendations for routine antibiotic prophylaxis in patients with cirrhosis and upper gastrointestinal bleeding should be reassessed and that higher quality randomized clinical trial data are needed.

Corresponding Author: Connor Prosty, MD, Faculty of Medicine, McGill University Health Centre, 1001 Decarie Blvd, E5-1820, Montréal, QC H4A 3J1, Canada (connor.prosty@mail.mcgill.ca).

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