Oral Antibiotics Reduce Intestinal Necrosis in Acute Mesenteric Ischemia: A Prospective Cohort Study

Am J Gastroenterol. 2019 Feb;114(2):348-351. doi: 10.1038/s41395-018-0389-9.

Abstract

Objectives: To identify treatments likely to prevent progression towards irreversible transmural intestinal necrosis (ITIN) in acute mesenteric ischemia (AMI).

Methods: Prospective observational cohort study from a French intestinal stroke center. Multivariate analysis using a time-dependent Cox regression model.

Results: Between 2009 and 2015, 67 patients with AMI were included. ITIN occurred in 34% of patients and mortality was 13%. Oral antibiotics was independently associated with a decreased risk of ITIN (HR: 0.16 (95% CI = 0.03-0.62); p = 0.01).

Conclusions: By decreasing luminal bacterial load and translocation, oral antibiotics in addition to early revascularization might reduce progression of AMI to ITIN.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Anticoagulants / therapeutic use
  • Blood Transfusion
  • Cohort Studies
  • Disease Progression
  • Female
  • Fluid Therapy
  • Humans
  • Intestines / pathology*
  • Male
  • Mesenteric Ischemia / pathology
  • Mesenteric Ischemia / therapy*
  • Mesenteric Vascular Occlusion / therapy*
  • Middle Aged
  • Necrosis
  • Proportional Hazards Models
  • Prospective Studies
  • Proton Pump Inhibitors / therapeutic use
  • Vascular Surgical Procedures

Substances

  • Anti-Bacterial Agents
  • Anticoagulants
  • Proton Pump Inhibitors