scholarly journals Fungal dysbiosis in cirrhtic patients due to the use of antimicrobials. Risk or benefit?

2021 ◽  
Vol 6 (2) ◽  

There is a significantly marked fungal dysbiosis in cirrhotic patients, which changes differentially with the use of antibiotics and proton pump inhibitors, although it is known that patients with cirrhosis have a fairly weakened immune system, therefore, these have a greater risk of developing bacterial infections, the use in this type of patients of drugs such as proton pump inhibitors and antimicrobials, represents an even greater risk of developing, no longer bacterial infections, but of fungal origin [1].

2013 ◽  
Vol 58 ◽  
pp. S92-S93
Author(s):  
B. Imperatrice ◽  
C. Lucidi ◽  
V. Giannelli ◽  
V. Di Gregorio ◽  
M. Giusto ◽  
...  

2011 ◽  
Vol 54 ◽  
pp. S74
Author(s):  
C. Lucidi ◽  
V. Giannelli ◽  
M. Giusto ◽  
E. Gangitano ◽  
O. Riggio ◽  
...  

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Bashir Ahmed Shaikh ◽  
Zahid Ali Shaikh ◽  
Aftab Hussain Shah ◽  
Aneel Kumar

Objectives: The current study aimed to determine the Spontaneous Bacterial Peritonitis (SBP) risk due to increased use of Proton Pump Inhibitors (PPIs) among cirrhotic patients with ascites. Methods: This retrospective case-control study was conducted at Chandka Medical College & Hospital, Larkana from March 2013 to February 2014, involving 215 cirrhotic patients with ascites. Paracentesis was performed to distinguish cirrhotic patients with SBP and Polymorphonuclear Neutrophil (PMN) count ≥ 250 neutrophils/mm3 (cases) and non-SBP with PMN count < 250 neutrophils/mm3 (controls). The demographic details, history of PPIs use before admission and duration of Chronic Liver Disease (CLD) were inquired and statistical analysis was carried through SPSS Version 23.0. Results: Increased pre-hospital PPI intake was observed among cirrhotic patients with SBP (69.8%) as compared to those without SBP (48.8%; p = 0.014). The mean duration of PPI use was 19.16 ± 4.772 days, and it was more significant among older cirrhotic patients (p < 0.05). Increased duration of CLD was observed among PPI users, i.e. 20.47 ± 6.305 months vs. 18.95 ± 5.527 months among non-PPI users (p < 0.05). Conclusions: Our results show that cirrhotic patients with ascites consuming PPIs are more likely to develop SBP as compared to non-PPI users. doi: https://doi.org/10.12669/pjms.37.4.3476 How to cite this:Shaikh BA, Shaikh ZA, Shah AH, Kumar A. Determining the Risk of Spontaneous Bacterial Peritonitis due to increase use of Proton Pump Inhibitors among cirrhotic patients with ascites. Pak J Med Sci. 2021;37(4):---------.   doi: https://doi.org/10.12669/pjms.37.4.3476 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2019 ◽  
Vol 11 (6) ◽  
pp. 522-530 ◽  
Author(s):  
Matthew Fasullo ◽  
Prashanth Rau ◽  
Dong-Qi Liu ◽  
Erik Holzwanger ◽  
Jomol P Mathew ◽  
...  

2018 ◽  
Vol 5 (3) ◽  
pp. 23
Author(s):  
Talles Bazeia Lima ◽  
Giovanni Faria Silva ◽  
Fernando Gomes Romeiro

Esophageal varices develop in half of cirrhotic patients. Endoscopic variceal band ligation is the current treatment for acute bleeding and applicable for primary and secondary prophylaxis. However, there is a risk of complications, including ligationinduced ulcer bleeding. The aim of this study is to review the current diagnosis, management and prophylaxis of bleeding related to post-esophageal variceal band-ligation ulcers in cirrhotic patients. PubMed and Google Scholar were searched for English language articles about the theme. The main findings were that Child-Pugh class C, higher model of end-stage liver disease, emergency ligation, presence of hepatocellular carcinoma, peptic esophagitis and bacterial infection were reported as the most important risk factors for post-banding ulcer hemorrhage. There are few studies with proton pump inhibitors and sucralfate showing size reduction of post-banding ulcers. Many treatment modalities have been used to control post band ulcer bleeding, such as band local injection of epinephrine or cyanoacrylate, balloon tamponade, stent placement and ligation of the ulcerated bleeding site. However, the optimal management remains uncertain. The principal conclusions of the study were that post-banding ulcer bleeding is potentially life-threatening and must be suspected in the presence of hematemesis, melena or anemia after endoscopic variceal band ligation (EVL). Predictors of rebleeding must be assessed and controlled as much as possible before band ligation. The post-banding treatment with proton pump inhibitors or sucralfate seems advisable, in particular for high-risk patients. Further investigation and new approaches are still required to achieve optimal management of this complication.


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