Open Access

Antibiotic prophylaxis vs. on‑demand antibiotic treatment in endoscopic therapy for variceal hemorrhage: A meta‑analysis of randomized controlled trials

  • Authors:
    • Zhang Tao
    • Wenfeng Pu
    • Yuhong Guo
    • Yan Zhang
    • Xiaobo Tang
    • Ying Hou
    • Dan Hu
    • Jian Chen
    • Juan Yang
    • Zhonghan Du
    • Siqing Li
    • Shenggang Feng
  • View Affiliations

  • Published online on: June 28, 2024     https://doi.org/10.3892/etm.2024.12629
  • Article Number: 340
  • Copyright: © Tao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to conduct a meta‑analysis for elucidating the effects of antibiotic prophylaxis on infection, rebleeding and mortality in patients who underwent endoscopic therapy for variceal hemorrhage. Articles on antibiotic prophylaxis and on‑demand antibiotic administration following endoscopic therapy for acute variceal bleeding were searched on PubMed, Embase and Cochrane Library between January 1959 and February 2024, to elucidate whether the use of prophylactic antibiotics was necessary. The quality of randomized controlled trials (RCTs) was assessed using the Cochrane risk‑of‑bias assessment tool and RevMan software version 5.4.1 was used for meta‑analysis of the data. The current meta‑analysis included four RCTs and 322 patients with acute variceal bleeding who underwent endoscopic therapy. All included studies were of high quality according to the Cochrane risk‑of‑bias assessment tool. According to the results of the meta‑analysis, the incidence of infection in the prophylactic antibiotic group was significantly lower than that in the on‑demand group [odds ratio (OR), 0.31; 95% confidence interval (CI), 0.13‑0.74; P=0.009]. The prophylactic antibiotic group also exhibited a lower incidence of rebleeding compared with that of the on‑demand group (OR, 0.37; 95% CI, 0.19‑0.72; P=0.003). No significant differences were noted in the incidence of mortality between the two groups (OR, 0.92; 95% CI, 0.45‑1.92; P=0.83). In conclusion, the data indicated that antibiotic prophylaxis is recommended to be used in patients who have undergone endoscopic therapy for variceal hemorrhage.
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September-2024
Volume 28 Issue 3

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Tao Z, Pu W, Guo Y, Zhang Y, Tang X, Hou Y, Hu D, Chen J, Yang J, Du Z, Du Z, et al: Antibiotic prophylaxis vs. on‑demand antibiotic treatment in endoscopic therapy for variceal hemorrhage: A meta‑analysis of randomized controlled trials. Exp Ther Med 28: 340, 2024.
APA
Tao, Z., Pu, W., Guo, Y., Zhang, Y., Tang, X., Hou, Y. ... Feng, S. (2024). Antibiotic prophylaxis vs. on‑demand antibiotic treatment in endoscopic therapy for variceal hemorrhage: A meta‑analysis of randomized controlled trials. Experimental and Therapeutic Medicine, 28, 340. https://doi.org/10.3892/etm.2024.12629
MLA
Tao, Z., Pu, W., Guo, Y., Zhang, Y., Tang, X., Hou, Y., Hu, D., Chen, J., Yang, J., Du, Z., Li, S., Feng, S."Antibiotic prophylaxis vs. on‑demand antibiotic treatment in endoscopic therapy for variceal hemorrhage: A meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 28.3 (2024): 340.
Chicago
Tao, Z., Pu, W., Guo, Y., Zhang, Y., Tang, X., Hou, Y., Hu, D., Chen, J., Yang, J., Du, Z., Li, S., Feng, S."Antibiotic prophylaxis vs. on‑demand antibiotic treatment in endoscopic therapy for variceal hemorrhage: A meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 28, no. 3 (2024): 340. https://doi.org/10.3892/etm.2024.12629