Most Read Articles
Pearl Toh, 15 Jul 2019
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from the large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
15 Jul 2019
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.
2 days ago
Health-related quality of life (HRQoL) among patients with kidney stone is worse in those who are young and female than those who are older and male, according to a recent study. Non-Caucasian patients also have a lower HRQoL.
Tristan Manalac, 3 days ago
In patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PPCI), admission Killip classification and creatinine and troponin levels are important cardiac mortality predictors, according to a recent Singapore study.

Norfloxacin yields survival gains in certain patients with advanced cirrhosis

01 Oct 2018

The fluoroquinolone norfloxacin does not appear to reduce 6-month mortality in patients with advanced cirrhosis, according to a study. However, the drug confers survival benefits among those with low ascites fluid protein concentrations.

A total of 291 adult patients with Child-Pugh class C cirrhosis who had not received recent fluoroquinolone therapy were randomized to treatment with norfloxacin 400 mg (n=144) or placebo (n=147) once-daily for 6 months.

Patients were evaluated monthly for the first 6 months and at 9 and 12 months thereafter. The primary endpoint was 6-month mortality, estimated by the Kaplan-Meier method, which censored spontaneous bacterial peritonitis, liver transplantation or loss during follow up.

The 6-month mortality estimate did not differ significantly between the two treatment groups, 14.8 percent with norfloxacin vs 19.7 percent with placebo (p=0.21).

However, competing risk analysis taking liver transplantation into account showed that the cumulative incidence of death at 6 months was less common in the norfloxacin group than in the placebo group (subdistribution hazard ratio [SHR], 0.59; 95 percent CI, 0.35–0.99).

The protective effect of the drug on the risk of death at 6 months was pronounced among patients with lower ascites fluid protein concentrations (<15 g/L; SHR, 0.35; 0.13–0.93) and absent among those with higher ascites fluid protein concentrations (15 g/L; SHR, 1.39; 0.42–4.57).

Norfloxacin substantially reduced the incidence of any and Gram-negative bacterial infections without increasing infections caused by Clostridium difficile or multiresistant bacteria. This suggests that the drug may prevent some infections, but not the development of spontaneous bacterial peritonitis and other noninfectious, liver-related complications, as researchers pointed out.

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Most Read Articles
Pearl Toh, 15 Jul 2019
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from the large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
15 Jul 2019
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.
2 days ago
Health-related quality of life (HRQoL) among patients with kidney stone is worse in those who are young and female than those who are older and male, according to a recent study. Non-Caucasian patients also have a lower HRQoL.
Tristan Manalac, 3 days ago
In patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PPCI), admission Killip classification and creatinine and troponin levels are important cardiac mortality predictors, according to a recent Singapore study.