Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1186/1471-230X-13-13 http://hdl.handle.net/11449/74385 |
Resumo: | Background: Hepatic encephalopathy (HE) is a severe complication in patients with hepatic cirrhosis, which causes numerous hospital admissions and deaths. Antibiotics are the best options in HE treatment, but head-to-head comparisons between these drugs are scarce. Erythromycin combines the antimicrobial effect and prokinetic properties in the same drug, but it has never been used in HE treatment. Our aim was to evaluate the efficacy of erythromycin as an HE treatment.Methods: We achieved a randomized controlled trial of adult patients with HE and hepatic cirrhosis admitted in our hospital. After randomization, the subjects received either erythromycin 250 mg or neomycin 1 g orally QID until hospital discharge or prescription of another antibiotic. All subjects were blindly evaluated every day towards quantifying clinical, neuropsychometric, hepatic and renal exams. Statistical analysis was employed to compare the groups and correlate the variables with hospitalization duration.Results: 30 patients were evaluated (15 treated with each drug). At hospital admission, the groups were homogeneous, but the erythromycin group subjects achieved a shorter hospitalization stay (p = 0.032) and a more expressive reduction in alanine aminotranspherase levels (p = 0.026). Hospitalization duration was positively correlated with C reactive protein levels measured previous to (p = 0.015) and after treatment (p = 0.01).Conclusions: In the sample evaluated erythromycin was associated with significant reductions in hospital stay and in alanine aminotranspherase values. Hospitalization time was positive correlated with C reactive protein levels measured before and after the treatments. © 2013 Romeiro et al.; licensee BioMed Central Ltd. |
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Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind studyErythromycinHepatic encephalopathyLiver cirrhosisNeomycinalanine aminotransferaseantibiotic agentC reactive proteinerythromycinerythromycin estolateneomycinadultalanine aminotransferase blood levelantibiotic therapyclinical articleclinical evaluationclinical examinationcontrolled studydouble blind proceduredrug efficacyfemalehepatic encephalopathyhospital admissionhospital dischargehospitalizationhumankidney examinationlength of stayliver cirrhosisliver examinationmaleneuropsychological testprescriptionprotein blood levelquantitative analysisrandomizationrandomized controlled trialtreatment responseAdministration, OralAdultAgedAlanine TransaminaseAnti-Bacterial AgentsC-Reactive ProteinDose-Response Relationship, DrugDouble-Blind MethodFemaleHepatic EncephalopathyHumansLength of StayLiver CirrhosisMaleMiddle AgedTreatment OutcomeBackground: Hepatic encephalopathy (HE) is a severe complication in patients with hepatic cirrhosis, which causes numerous hospital admissions and deaths. Antibiotics are the best options in HE treatment, but head-to-head comparisons between these drugs are scarce. Erythromycin combines the antimicrobial effect and prokinetic properties in the same drug, but it has never been used in HE treatment. Our aim was to evaluate the efficacy of erythromycin as an HE treatment.Methods: We achieved a randomized controlled trial of adult patients with HE and hepatic cirrhosis admitted in our hospital. After randomization, the subjects received either erythromycin 250 mg or neomycin 1 g orally QID until hospital discharge or prescription of another antibiotic. All subjects were blindly evaluated every day towards quantifying clinical, neuropsychometric, hepatic and renal exams. Statistical analysis was employed to compare the groups and correlate the variables with hospitalization duration.Results: 30 patients were evaluated (15 treated with each drug). At hospital admission, the groups were homogeneous, but the erythromycin group subjects achieved a shorter hospitalization stay (p = 0.032) and a more expressive reduction in alanine aminotranspherase levels (p = 0.026). Hospitalization duration was positively correlated with C reactive protein levels measured previous to (p = 0.015) and after treatment (p = 0.01).Conclusions: In the sample evaluated erythromycin was associated with significant reductions in hospital stay and in alanine aminotranspherase values. Hospitalization time was positive correlated with C reactive protein levels measured before and after the treatments. © 2013 Romeiro et al.; licensee BioMed Central Ltd.Department of Internal Medicine Faculdade de Medicina de Botucatu UNESP - Universidade Estadual Paulista, BotucatuBiological and Health Sciences Institute Campus Médio Araguaia UFMT -Universidade Federal do Mato Grosso, Barra do GarçasHealth Sciences Center UNCISAL - Universidade Estadual de Ciências da Saúde de Alagoas, MaceióDepartment of Physics and Biophysics Instituto de Biociências de Botucatu UNESP - Universidade Estadual Paulista, BotucatuDepartment of Internal Medicine - Botucatu Medical School UNESP- Universidade Estadual Paulista, Distrito de Rubião Jr. s/n zip code 18 608 917, Botucatu, São PauloDepartment of Internal Medicine Faculdade de Medicina de Botucatu UNESP - Universidade Estadual Paulista, BotucatuDepartment of Physics and Biophysics Instituto de Biociências de Botucatu UNESP - Universidade Estadual Paulista, BotucatuDepartment of Internal Medicine - Botucatu Medical School UNESP- Universidade Estadual Paulista, Distrito de Rubião Jr. s/n zip code 18 608 917, Botucatu, São PauloUniversidade Estadual Paulista (Unesp)Universidade Federal de Mato Grosso (UFMT)Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL)Romeiro, Fernando Gomes [UNESP]da Silva Yamashiro, Fabio [UNESP]Américo, Madileine FrancelyCorá, Luciana AparecidaSilva, Giovanni Faria [UNESP]Miranda, JoséRicardodeArruda [UNESP]Caramori, Carlos Antonio [UNESP]2014-05-27T11:28:10Z2014-05-27T11:28:10Z2013-01-16info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1186/1471-230X-13-13BMC Gastroenterology, v. 13, n. 1, 2013.1471-230Xhttp://hdl.handle.net/11449/7438510.1186/1471-230X-13-13WOS:0003140623000012-s2.0-848722040452-s2.0-84872204045.pdf63226042005106765518720125698768Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengBMC Gastroenterology2.731info:eu-repo/semantics/openAccess2024-08-14T17:22:25Zoai:repositorio.unesp.br:11449/74385Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-14T17:22:25Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study |
title |
Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study |
spellingShingle |
Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study Romeiro, Fernando Gomes [UNESP] Erythromycin Hepatic encephalopathy Liver cirrhosis Neomycin alanine aminotransferase antibiotic agent C reactive protein erythromycin erythromycin estolate neomycin adult alanine aminotransferase blood level antibiotic therapy clinical article clinical evaluation clinical examination controlled study double blind procedure drug efficacy female hepatic encephalopathy hospital admission hospital discharge hospitalization human kidney examination length of stay liver cirrhosis liver examination male neuropsychological test prescription protein blood level quantitative analysis randomization randomized controlled trial treatment response Administration, Oral Adult Aged Alanine Transaminase Anti-Bacterial Agents C-Reactive Protein Dose-Response Relationship, Drug Double-Blind Method Female Hepatic Encephalopathy Humans Length of Stay Liver Cirrhosis Male Middle Aged Treatment Outcome |
title_short |
Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study |
title_full |
Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study |
title_fullStr |
Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study |
title_full_unstemmed |
Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study |
title_sort |
Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study |
author |
Romeiro, Fernando Gomes [UNESP] |
author_facet |
Romeiro, Fernando Gomes [UNESP] da Silva Yamashiro, Fabio [UNESP] Américo, Madileine Francely Corá, Luciana Aparecida Silva, Giovanni Faria [UNESP] Miranda, JoséRicardodeArruda [UNESP] Caramori, Carlos Antonio [UNESP] |
author_role |
author |
author2 |
da Silva Yamashiro, Fabio [UNESP] Américo, Madileine Francely Corá, Luciana Aparecida Silva, Giovanni Faria [UNESP] Miranda, JoséRicardodeArruda [UNESP] Caramori, Carlos Antonio [UNESP] |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (Unesp) Universidade Federal de Mato Grosso (UFMT) Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL) |
dc.contributor.author.fl_str_mv |
Romeiro, Fernando Gomes [UNESP] da Silva Yamashiro, Fabio [UNESP] Américo, Madileine Francely Corá, Luciana Aparecida Silva, Giovanni Faria [UNESP] Miranda, JoséRicardodeArruda [UNESP] Caramori, Carlos Antonio [UNESP] |
dc.subject.por.fl_str_mv |
Erythromycin Hepatic encephalopathy Liver cirrhosis Neomycin alanine aminotransferase antibiotic agent C reactive protein erythromycin erythromycin estolate neomycin adult alanine aminotransferase blood level antibiotic therapy clinical article clinical evaluation clinical examination controlled study double blind procedure drug efficacy female hepatic encephalopathy hospital admission hospital discharge hospitalization human kidney examination length of stay liver cirrhosis liver examination male neuropsychological test prescription protein blood level quantitative analysis randomization randomized controlled trial treatment response Administration, Oral Adult Aged Alanine Transaminase Anti-Bacterial Agents C-Reactive Protein Dose-Response Relationship, Drug Double-Blind Method Female Hepatic Encephalopathy Humans Length of Stay Liver Cirrhosis Male Middle Aged Treatment Outcome |
topic |
Erythromycin Hepatic encephalopathy Liver cirrhosis Neomycin alanine aminotransferase antibiotic agent C reactive protein erythromycin erythromycin estolate neomycin adult alanine aminotransferase blood level antibiotic therapy clinical article clinical evaluation clinical examination controlled study double blind procedure drug efficacy female hepatic encephalopathy hospital admission hospital discharge hospitalization human kidney examination length of stay liver cirrhosis liver examination male neuropsychological test prescription protein blood level quantitative analysis randomization randomized controlled trial treatment response Administration, Oral Adult Aged Alanine Transaminase Anti-Bacterial Agents C-Reactive Protein Dose-Response Relationship, Drug Double-Blind Method Female Hepatic Encephalopathy Humans Length of Stay Liver Cirrhosis Male Middle Aged Treatment Outcome |
description |
Background: Hepatic encephalopathy (HE) is a severe complication in patients with hepatic cirrhosis, which causes numerous hospital admissions and deaths. Antibiotics are the best options in HE treatment, but head-to-head comparisons between these drugs are scarce. Erythromycin combines the antimicrobial effect and prokinetic properties in the same drug, but it has never been used in HE treatment. Our aim was to evaluate the efficacy of erythromycin as an HE treatment.Methods: We achieved a randomized controlled trial of adult patients with HE and hepatic cirrhosis admitted in our hospital. After randomization, the subjects received either erythromycin 250 mg or neomycin 1 g orally QID until hospital discharge or prescription of another antibiotic. All subjects were blindly evaluated every day towards quantifying clinical, neuropsychometric, hepatic and renal exams. Statistical analysis was employed to compare the groups and correlate the variables with hospitalization duration.Results: 30 patients were evaluated (15 treated with each drug). At hospital admission, the groups were homogeneous, but the erythromycin group subjects achieved a shorter hospitalization stay (p = 0.032) and a more expressive reduction in alanine aminotranspherase levels (p = 0.026). Hospitalization duration was positively correlated with C reactive protein levels measured previous to (p = 0.015) and after treatment (p = 0.01).Conclusions: In the sample evaluated erythromycin was associated with significant reductions in hospital stay and in alanine aminotranspherase values. Hospitalization time was positive correlated with C reactive protein levels measured before and after the treatments. © 2013 Romeiro et al.; licensee BioMed Central Ltd. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-01-16 2014-05-27T11:28:10Z 2014-05-27T11:28:10Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1186/1471-230X-13-13 BMC Gastroenterology, v. 13, n. 1, 2013. 1471-230X http://hdl.handle.net/11449/74385 10.1186/1471-230X-13-13 WOS:000314062300001 2-s2.0-84872204045 2-s2.0-84872204045.pdf 6322604200510676 5518720125698768 |
url |
http://dx.doi.org/10.1186/1471-230X-13-13 http://hdl.handle.net/11449/74385 |
identifier_str_mv |
BMC Gastroenterology, v. 13, n. 1, 2013. 1471-230X 10.1186/1471-230X-13-13 WOS:000314062300001 2-s2.0-84872204045 2-s2.0-84872204045.pdf 6322604200510676 5518720125698768 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
BMC Gastroenterology 2.731 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
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1808128115666321408 |