Most Read Articles
Yesterday
Exposure to corticosteroids in patients with autoimmune hepatitis (AIH) appears to contribute to increased risks of cataract, diabetes and bone fractures, a study has found. Notably, the fracture risk is elevated at low doses, while the risk of adverse events overall is dose-dependent and is reversible.
6 days ago
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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
Yesterday
Exposure to corticosteroids in patients with autoimmune hepatitis (AIH) appears to contribute to increased risks of cataract, diabetes and bone fractures, a study has found. Notably, the fracture risk is elevated at low doses, while the risk of adverse events overall is dose-dependent and is reversible.
6 days ago
In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.
Elvira Manzano, 12 Nov 2019
Supplementation with omega-3 fatty acids or vitamin D3 for up to 5 years has no effect on kidney function in adults with type 2 diabetes (T2D), the VITAL-DKD* ancillary study has shown.
Jairia Dela Cruz, 4 days ago
Many patients with nonvalvular atrial fibrillation (NVAF) in Thailand use anticoagulants, but the uptake of nonvitamin-K oral anticoagulants remains suboptimal despite showing an upward trend, according to data from the COOL-AF registry presented at the European Society of Cardioloy (ESC) Asia Congress 2019 with APSC and AFC.