@entity2259 and bacterascites after endoscopic sclerotherapy for XXXX esophageal varices and prevention by intravenous @entity3524 : a randomized trial.

@entity1 @entity548 @entity843 @entity3524 @entity281 @entity2259 @entity922
Thirty-one @entity1 were randomized during 39 episodes of @entity548 to receive either 1 g of intravenous @entity3524 (19 @entity1 ) or no antibiotic (20 @entity1 ) immediately before emergency endoscopic sclerotherapy. Blood was obtained for culture before and at 5 minutes, 4 hours, and 24 hours after the procedure. Specimens for culture were taken from the endoscope tip and channel, water bottle, and injection needle after sclerotherapy. When @entity843 was present (5 @entity1 in the antibiotic group, 7 in the control group), fluid was obtained by paracentesis before endoscopy and at 4 and 24 hours. @entity2259 occurred in 1 of 19 @entity1 in the antibiotic group (5.3%), compared with 6 of 19 in the control group (31.6%; p = .04). The cultured organisms were oral flora and usually also contaminated the endoscope and needle. No bacteria were cultured from ascitic fluid in any @entity1 nor was the ascitic fluid white cell count elevated. @entity922 attributable to sclerotherapy did not develop in any @entity1 . In conclusion, the frequency of @entity2259 after endoscopic sclerotherapy for @entity548 esophageal varices can be reduced by prophylactic administration of intravenous @entity3524 . However, this may not be clinically relevant, given the absence of bacterascites and @entity281 in this study. These findings do not support the routine use of antibiotics before sclerotherapy.
