Oral Antibiotics Reduce Intestinal Necrosis in Acute Mesenteric Ischemia: A Prospective Cohort Study.

Abstract

OBJECTIVES:

To identify treatments likely to prevent progression towards irreversible transmural intestinal necrosis (ITIN) in acute mesenteric ischemia (AMI).

METHODS:

Prospective observational cohort study from a French intestinal stroke center. Multivariate analysis using a time-dependent Cox regression model.

RESULTS:

Between 2009 and 2015, 67 patients with AMI were included. ITIN occurred in 34% of patients and mortality was 13%. Oral antibiotics was independently associated with a decreased risk of ITIN (HR: 0.16 (95% CI = 0.03-0.62); p = 0.01).

CONCLUSIONS:

By decreasing luminal bacterial load and translocation, oral antibiotics in addition to early revascularization might reduce progression of AMI to ITIN.

• Authors: Alexandre Nuzzo, Leon Maggiori, Catherine Paugam-Burtz, Dominique Cazals-Hatem, Maxime Ronot, Audrey Huguet, Aymeric Becq, Yves Castier, Emmanuel Weiss, Aurélie Plessier, Alexy Tran-Dinh, Francisca Joly, Yves Panis, Yoram Bouhnik, Nathalie Gault, Olivier Corcos
• Journal: The American journal of gastroenterology (Am J Gastroenterol) Vol. 114 Issue 2 Pg. 348-351 (02 2019) ISSN: 1572-0241 [Electronic] United States
• PMID: 30538292 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Anticoagulants
• Proton Pump Inhibitors

Topics

• Administration, Oral
• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Anticoagulants (therapeutic use)
• Blood Transfusion
• Cohort Studies
• Disease Progression
• Female
• Fluid Therapy
• Humans
• Intestines (pathology)
• Male
• Mesenteric Ischemia (pathology, therapy)
• Mesenteric Vascular Occlusion (therapy)
• Middle Aged
• Necrosis
• Proportional Hazards Models
• Prospective Studies
• Proton Pump Inhibitors (therapeutic use)
• Vascular Surgical Procedures