Risk factors for antibiotic prophylaxis failure in patients with liver cirrhosis and upper gastrointestinal bleeding

Objective To investigate the risk factors for antibiotic prophylaxis failure in patients with liver cirrhosis and upper gastrointestinal bleeding. Methods Eighty- two patients with liver cirrhosis and upper gastrointestinal bleeding who were admitted to our hospital from January 2011 to June 2014 were analyzed retrospectively. All patients received third- generation cephalosporins as the antibiotic prophylaxis for 7 days. The therapeutic effect of prophylaxis within two weeks was analyzed,and the clinical features were compared between prophylaxis response group and non- response group. The t- test or Mann- Whitney U test was applied for comparison of continuous data between groups,the chi- square test was applied for comparison of categorical data between groups,and the logistic regression analysis was applied to determine the risk factors for antibiotic prophylaxis failure. Results A total of 38 patients( 46. 4%) developed secondary infection.There were significant differences in prothrombin time,proportion of patients admitted to the intensive care unit( ICU),duration of ICU stay,proportion of patients who received deep venipuncture,Child- Pugh classification,and Child- Pugh score between the prophylaxis response group and non- response group( P < 0. 05). Child- Pugh classification( OR = 2. 455,95% CI: 1. 01- 5. 97,P = 0. 048) and admission to the ICU( OR = 4. 12,95% CI: 1. 32- 12. 83,P = 0. 015) were the independent risk factors for antibiotic prophylaxis failure.Conclusion Antibiotic prophylaxis with third- generation cephalosporins has a high failure rate,and admission to the ICU and a high Child- Pugh classification are the independent risk factors for antibiotic prophylaxis failure.