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Abstract UGIB is a common and fatal complication in cirrhotic patients. Increased risk of bacterial infection driven by portal hypertension and BT was observed among patients with cirrhosis during hospitalization for UGIB. Current clinical guidelines recommend that prophylactic antibiotic should be instituted for patients with cirrhosis and UGIB, regardless of variceal hemorrhage or nonvariceal sources.Recently, the issue of the beneficial role of antibiotic prophylaxis in compensated cirrhotic patients with UGIB began to be doubted under the concept of low risk of bacterial infection and mortality rate. So, the current work was conducted to assess the impact of using prophylactic antibiotic in Child A cirrhotic patients presented with UGIB.A total of 68 patients cirrhotic Child class A patients presented with UGIB. Those patients were randomly classified into two equal groups: prophylaxis group in which patients received antibiotic prophylaxis with (IV) ceftriaxone 1gm every24h for 7 days and the other group didn’t receive antibiotic prophylaxis.The patients were assessed for occurrence of infection as SBP or other infections by clinical, laboratory, radiological assessment. Culture was done based on the suspected source of infection as ascitic fluid, urine, sputum and/or blood culture. Both groups had insignificant differences as regard demographic and baseline laboratory data. The most frequent endoscopic finding was esophageal varices and band ligation was the most frequent reported performed procedure.At 3rd day of admission, prophylaxis group had lower infection rate in comparison to the control group (8.8% vs. 14.7%) with insignificant difference between two groups. At 7th day of admission; patients in prophylaxis group had no manifestations of ascitic fluid or other sites of infection based on clinical and laboratory data. Two patients in the control group had manifestations of ascitic fluid infection and another patient had clinical manifestation of chest infection in form of productive cough with yellowish sputum.Both groups had insignificant differences as regard hospital stay and admission to ICU. There was only one patient who was deteriorated and died in the control group. And yet, frequency of re-bleeding was significantly higher among the control group (2 (5.9%) vs. 9 (26.5%); p= 0.02). In conclusion, the current study suggested that cirrhotic patients with Child class A who presented with UGIB and received antibiotic prophylaxis were less liable to rebleeding after successful endoscopic treatment of UGIB. Any yet no effect was found on the infection rate, mortality and frequency of admission to ICU. |