Copyright
©The Author(s) 2024.
World J Gastroenterol. Jan 21, 2024; 30(3): 238-251
Published online Jan 21, 2024. doi: 10.3748/wjg.v30.i3.238
Published online Jan 21, 2024. doi: 10.3748/wjg.v30.i3.238
Table 1 List of antibiotics included in the study
ATC code | Type of antibiotics |
J01AA | Tetracyclines |
J01BA | Amphenicols |
J01BB | Macrolides, lincosamides and streptogramins |
J01CA | Penicillins with extended spectrum |
J01CE | Beta-lactamase sensitive penicillins |
J01CF | Beta-lactamase resistant penicillins |
J01CR | Combinations of penicillins, including beta-lactamase inhibitors |
J01DB | First-generation cephalosporins |
J01DC | Second-generation cephalosporins |
J01DD | Third-generation cephalosporins |
J01DE | Fourth-generation cephalosporins |
J01DF | Monobactams |
J01DH | Carbapenems |
J01EA | Trimethoprim and derivatives |
J01EB | Short-acting sulfonamides |
J01EC | Intermediate-acting sulfonamides |
J01ED | Long-acting sulfonamides |
J01EE | Combinations of sulfonamides |
J01FA | Macrolides |
J01FF | Lincosamides |
J01FG | Streptogramins |
J01GA | Aminoglycoside antibacterials |
J01GB | Other aminoglycosides |
J01MA | Fluoroquinolones |
J01MB | Other quinolone antibacterials |
J01XA | Glycopeptide antibacterials |
J01XB | Polymyxins |
J01XC | Steroid antibacterials |
J01XD | Imidazole derivatives |
J01XE | Nitrofuran derivatives |
J01XX | Other antibacterials |
Table 2 Distribution of facilities and cases across regions in Japan
Region | Number of facilities | Number of cases |
Hokkaido | 3 | 34 |
Tohoku | 2 | 5 |
Kanto | 14 | 319 |
Chubu | 5 | 32 |
Kansai | 11 | 359 |
Chugoku/Shikoku | 1 | 2 |
Kyushu/Okinawa | 10 | 229 |
Table 3 Patient characteristics, missing data, and comparison of standardized mean differences, n (%)
Before Imputation and IPTW | After imputation and IPTW | ||||
Prophylactic groups | Non-prophylactic groups | Missing (%) | SMD | SMD | |
Variables | n = 232 | n = 558 | |||
Age, yr | 0 | 0.18 | 0.01 | ||
< 65 | 143 (61.6) | 322 (57.7) | |||
65-74 | 46 (19.8) | 144 (25.8) | |||
75-84 | 39 (16.8) | 75 (13.4) | |||
≥ 85 | 4 (1.7) | 17 (3.0) | |||
Sex, male (%) | 181 (78.0) | 417 (74.7) | 0 | 0.08 | < 0.01 |
Barthel index (%) | 17.3 | 0.10 | < 0.01 | ||
100 (full activity) | 83 (40.5) | 186 (41.5) | |||
1-99 | 63 (30.7) | 152 (33.9) | |||
0 (worst disability) | 59(28.8) | 110 (24.6) | |||
Child-Pugh score, median (IQR) | 8 (7-10) | 8 (7-10) | 12.9 | 0.05 | 0.03 |
Child-Pugh classification (%) | 10.1 | 0.06 | 0.02 | ||
A | 42 (19.4) | 93 (18.8) | |||
B | 110 (50.9) | 266 (53.7) | |||
C | 64 (29.6) | 136 (27.5) | |||
Presence of ascites | 67 (31.0) | 171 (34.5) | |||
Comorbidities | |||||
Charlson Comorbidity Index, median (IQR) | 4 (4-5) | 4 (4-5) | 0 | < 0.01 | 0.01 |
Maintenance hemodialysis | 3 (1.3) | 8 (1.4) | 0 | 0.01 | < 0.01 |
Hepatic cancer | 38 (16.4) | 112 (20.1) | 0 | 0.10 | < 0.01 |
Malignant tumor history | 29 (12.5) | 65 (11.6) | 0 | 0.03 | < 0.01 |
Alcohol-related disease | 127 (54.7) | 246 (44.1) | 0 | 0.21 | < 0.01 |
Past varix rupture history | 63 (27.2) | 127 (22.8) | 0 | 0.10 | < 0.01 |
Medications | |||||
Antiplatelet use | 3 (1.3) | 8 (1.4) | 0 | 0.01 | < 0.01 |
Anticoagulant use | 5 (2.2) | 8 (1.4) | 0 | 0.05 | < 0.01 |
NSAIDs use | 5 (2.2) | 13 (2.3) | 0 | 0.01 | < 0.01 |
Corticosteroid use | 0 (0) | 2 (0.4) | 0 | 0.09 | < 0.01 |
Acid blocker use | 214 (91.8) | 486 (87.1) | 0 | 0.15 | < 0.01 |
β blocker use | 26 (11.2) | 26 (4.7) | 0 | 0.24 | < 0.01 |
Laboratory data | |||||
Total bilirubin, mg/dL, median (IQR) | 1.6 (1-2.9) | 1.4 (0.9-2.4) | 3.2 | 0.13 | 0.02 |
Aspartate aminotransferase, U/L, median (IQR) | 54.5 (32.2-94.8) | 47 (31-83) | 2.2 | 0.09 | 0.01 |
Alanine aminotransferase, U/L, median (IQR) | 30.5 (20-47) | 27 (19-42) | 2.2 | 0.08 | < 0.01 |
Albumin | 4.6 | 0.11 | 0.02 | ||
> 3.5 g/dL | 37 (16.5) | 72 (13.6) | |||
2.8–3.5 g/dL | 97 (43.3) | 256 (48.3) | |||
< 2.8 g/dL | 90 (40) | 202 (38.1) | |||
White blood cell, /μL, median (IQR) | 7720 (5900-10700) | 7300 (5200-10400) | 1.8 | 0.15 | 0.01 |
Hemoglobin, g/dL, median (IQR) | 9 (7.3-10.5) | 8.5 (6.9-10.2) | 1.8 | 0.12 | < 0.01 |
Platelet, 103/μL, median (IQR) | 99 (72-139) | 103 (75-144) | 1.8 | < 0.01 | 0.02 |
C-reactive protein, mg/dL, median (IQR) | 0.3 (0.1-0.7) | 0.3 (0.1-0.8) | 4.7 | 0.03 | 0.04 |
Prothrombin time | 5.9 | 0.02 | < 0.01 | ||
> 70% | 48 (21.5) | 113 (21.7) | |||
40%-70% | 138 (61.9) | 324 (62.3) | |||
< 40% | 37 (16.6) | 83 (16.0) | |||
Activated partial thromboplastin time | 11.4 | 0.08 | 0.01 | ||
≤ 40 s | 185 (87.3) | 436 (89.3) | |||
40-60 s | 23 (10.8) | 47 (9.6) | |||
> 60 s | 4 (1.9) | 5 (1.0) | |||
eGFR < 30 mL/min/1.73 m2 | 19 (8.3) | 40 (7.3) | 1.9 | 0.03 | < 0.01 |
Shock index > 1 | 94 (41.4) | 197 (36.5) | 3 | 0.10 | < 0.01 |
Vasopressor use | 7 (3.0) | 19 (3.4) | 0 | 0.02 | < 0.01 |
RBC transfusion, Unit, median (IQR) | 4 (0-4) | 2.5 (0-4) | 0 | 0.09 | < 0.01 |
Table 4 Antibiotic use in prophylaxis group
Antibiotic class | Number of patients |
Carbapenems | 4 |
First-Generation Cephalosporins | 32 |
Second-Generation Cephalosporins | 51 |
Third-Generation Cephalosporins | 106 |
Beta-Lactamase Inhibitor Combinations | 14 |
Macrolides | 22 |
Lincosamides | 3 |
Table 5 Crude and inverse probability of treatment weighting outcomes, n (%)
Before imputation and IPTW | After imputation and IPTW | ||||
Outcomes | Prophylaxis group (n = 232) | Non-prophylaxis group (n = 558) | Odds ratio (95%CI) | Odds ratio (95%CI) | P value |
Composite outcome | 26 (11.2) | 53 (9.5) | 1.20 (0.72-1.96) | 1.11 (0.61-1.99) | 0.74 |
6-wk mortality | 16 (6.9) | 37 (6.6) | 1.04 (0.55-1.88) | 0.97 (0.47-1.98) | 0.93 |
4-wk rebleeding | 9 (3.9) | 16 (2.9) | 1.37 (0.57-3.08) | 1.21 (0.45-3.24) | 0.71 |
4-wk onset of SBP | 5 (2.2) | 10 (1.8) | 1.21 (0.37-3.44) | 1.20 (0.32-4.46) | 0.78 |
In-hospital mortality | 14 (6.0) | 34 (6.1) | 0.99 (0.50-1.84) | 0.89 (0.42-1.87) | 0.75 |
Rate ratio (95%CI) | Rate ratio (95%CI) | ||||
Length of hospital, median (IQR) | 8 (5-15) | 9 (6-15) | 1.01 (0.90-1.14) | 1.06 (0.94-1.19) | 0.34 |
Table 6 Outcomes of subgroup analysis
Child-Pugh classification | Odds ratio (95%CI) | P value | P for interaction |
A | 0.87 (0.22–3.34) | 0.84 | 0.32 |
B | 0.79 (0.46–1.38) | 0.41 | |
C | 1.91 (1.20–3.02) | 0.01 |
Table 7 Outcomes of sensitivity analysis
Analysis method | Odds ratio (95%CI) | P value |
IPTW | 1.11 (0.61-1.99) | 0.74 |
Propensity score matching | 1.12 (0.62-2.03) | 0.71 |
Duration of antibiotics | ||
2 d or more | 1.14 (0.59-2.20) | 0.70 |
3 d or more | 1.05 (0.50-2.21) | 0.91 |
4 d or more | 0.96 (0.43-2.18) | 0.93 |
Third-generation cephalosporins only | 1.57 (0.64-3.87) | 0.33 |
- Citation: Ichita C, Shimizu S, Goto T, Haruki U, Itoh N, Iwagami M, Sasaki A. Effectiveness of antibiotic prophylaxis for acute esophageal variceal bleeding in patients with band ligation: A large observational study. World J Gastroenterol 2024; 30(3): 238-251
- URL: https://www.wjgnet.com/1007-9327/full/v30/i3/238.htm
- DOI: https://dx.doi.org/10.3748/wjg.v30.i3.238