Daily Ciprofloxacin Treatment for Patients with Advanced Liver Disease Awaiting Liver Transplantation Reduces Hospitalizations

• Published in: Digestive diseases and sciences 2011-04, Vol.56 (4), p.1235-1241
• Main Authors: Minuk, G. Y., Hawkins, K., Kaita, K. D. E., Wong, S., Renner, E., Minuk, L., Uhanova, J.
• Format: Article
• Language: English
• Subjects: Adult; Albumin; Analysis; Anti-Infective Agents - therapeutic use; Bilirubin; Bilirubin - blood; Biochemistry; Biological and medical sciences; Blood; Ciprofloxacin; Ciprofloxacin - therapeutic use; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Health aspects; Hepatology; Hospitalization - statistics & numerical data; Humans; Liver; Liver Diseases - drug therapy; Liver Function Tests; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical examination; Medical research; Medical sciences; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Oncology; Original Article; Other diseases. Semiology; Prothrombin Time; Serum Albumin - metabolism; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Thrombin; Transplant Surgery; Transplantation; Treatment Outcome; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-010-1456-2

Background Progressive deterioration in liver function is a common cause of hepatic decompensation and indication for liver transplantation in patients with advanced liver disease. Previous studies in animal models of acute and chronic liver disease revealed that daily ciprofloxacin improves biochemical parameters of hepatic function. Aims The primary objective of this study was to determine whether hepatic function improves in patients with advanced liver disease after 1 month of daily ciprofloxacin therapy. A secondary objective was to determine whether ciprofloxacin treatment for 1 or 3 months results in fewer hospitalizations for decompensated liver disease. Methods Forty-four patients with advanced liver disease awaiting liver transplantation received oral ciprofloxacin (250 or 500 mg twice daily) or placebo for 1 ( n  = 22/group) or 3 ( n  = 10 ciprofloxacin, 14 placebo) months. Results Compared to placebo recipients, ciprofloxacin-treated patients had mild improvements in serum albumin levels (+1.5 versus −3.4%, p  = 0.026) while bilirubin and international normalized ratios (INR) of prothrombin times remained unchanged. Overall, fewer hospitalizations occurred in ciprofloxacin-treated patients (1/22, 5% versus 7/22, 32%, respectively, p  = 0.02) during the study period. Treatment was well tolerated and no resistant infections occurred in either cohort. Conclusions The results of this study suggest that daily ciprofloxacin may result in fewer hospitalizations for patients with advanced liver diseases awaiting liver transplantation but not by enhancing hepatic function.