Risk factors of cellulitis in cirrhosis and antibiotic prophylaxis in preventing recurrence

 
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Annals of Gastroenterology
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Τμήμα περιοδικού (EL)
2014 (EL)
Risk factors of cellulitis in cirrhosis and antibiotic prophylaxis in preventing recurrence (EN)
Sreesh, Sreejaya
Erachamveettil, Rooby Hamza
Vinayakumar, Kattoor Ramakrishnan
Narayanan, Premalatha
Joseph, Deni
Villyoth, Mashhood Padincharepurathu
Peter, George
Tank, Devang Chandrakanth
Govindaraju, Chethan
Background Cellulitis is a commonly encountered bacterial infection among cirrhotic patients apart from spontaneous bacterial peritonitis, urinary tract and respiratory infections. This study aimed to determine the risk factors of cellulitis in cirrhosis and whether antibiotic prophylaxis helps prevent recurrence of cellulitis.Methods The study was conducted in two phases. In phase 1, all cirrhotic patients admitted with cellulitis from August 2011 to August 2013 were taken as cases (n=70) and cirrhotic patients without cellulitis were included as controls (n=73). Baseline demographic data, comorbidities and investigations were noted and compared. In phase 2, the cases of phase 1 were divided into two groups, based on initiation of antibiotic prophylaxis at the time of discharge and were followed up for six months for recurrence of cellulitis.Results The main etiology of cirrhosis was alcohol and 68% of cases were Child C. Factors which showed signifi cance in univariate analysis were presence of diabetes mellitus, hepatic encephalopathy, platelet count, albumin level and model for end-stage liver disease (MELD) score. Using logistic regression, hepatic encephalopathy (OR 2.95, CI 1.01-8.45), albumin level <2.5 g/dL (OR 2.80, CI 1.32-5.92) and MELD >15 (OR 2.95, CI 1.39-6.27) emerged as significant factors associated with cellulitis. Cellulitis recurred in 20% and recurrence was significantly low among antibiotic prophylaxis group (15% vs. 50% P=0.048).Conclusions Hypoalbuminemia, and high MELD score are the risk factors for cellulitis in cirrhosis. Antibiotic prophylaxis can reduce the recurrence of cellulitis as in the case of spontaneous bacterial peritonitis.Keywords Cellulitis, cirrhosis, risk factors, recurrence, antibiotic prophylaxisAnn Gastroenterol 2014; 27 (4): 374-379 (EN)
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Ελληνική Γαστροεντερολογική Εταιρία
Annals of Gastroenterology
Αγγλική γλώσσα
2014-10-01
http://www.annalsgastro.gr/index.php/annalsgastro/article/view/1676
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 27, No 4 (2014); 374 (EN)



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