XXXX primary prophylaxis of bacterial infections in cirrhotic @entity1 with ascites: a double-blind randomized trial.

@entity1 @entity82 @entity4258 @entity281 @entity2259 @entity298
BACKGROUND/AIMS: @entity4258 is useful to prevent @entity281 in hospitalized cirrhotic @entity1 with low ascitic fluid protein concentrations. It is also effective in preventing the recurrence of spontaneous @entity298 . The aim of our study was to determine the efficacy of @entity4258 in the primary prophylaxis of gram-negative bacilli @entity281 in cirrhotic @entity1 with low ascitic fluid protein levels (<15 g/l). METHODS: One hundred and seven @entity1 were randomized to receive @entity4258 (400 mg/day; n=53) or placebo (n=54) for 6 months. The @entity1 had no history of @entity281 since @entity82 diagnosis and no active @entity281 . RESULTS: The probability of gram-negative @entity281 was significantly lower among @entity1 treated with @entity4258 than among those treated with placebo. Six gram-negative bacilli @entity281 occurred in the placebo group and none in the treatment group. Severe @entity281 (spontaneous @entity298 , @entity2259 ) developed in nine @entity1 in the placebo group (17%) and in one @entity1 in the @entity4258 group (2%; p<0.03). There was no between-group difference in the overall rate of @entity281 or in survival. In ten @entity1 from the @entity4258 group, gram-negative bacilli not present in baseline stool cultures were transiently isolated in follow-up cultures. CONCLUSIONS: These data show that primary prophylaxis with @entity4258 for 6 months is effective in the prevention of @entity281 caused by gram-negative bacilli in cirrhotic @entity1 with low ascitic fluid total protein levels.
