Skip to main content
Top
Published in: Digestive Diseases and Sciences 4/2011

01-04-2011 | Original Article

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

Authors: G. Y. Minuk, K. Hawkins, K. D. E. Kaita, S. Wong, E. Renner, L. Minuk, J. Uhanova

Published in: Digestive Diseases and Sciences | Issue 4/2011

Login to get access

Abstract

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.
Literature
1.
go back to reference Murray C, Lopez A. Mortality by cause for eight regions of the world: global burden of diseases study. Lancet. 1997;349(9061):1269–1276.PubMedCrossRef Murray C, Lopez A. Mortality by cause for eight regions of the world: global burden of diseases study. Lancet. 1997;349(9061):1269–1276.PubMedCrossRef
2.
go back to reference Runyon B. Management of adult patients with ascites caused by cirrhosis. Hepatology. 1998;27(1):264–272.PubMedCrossRef Runyon B. Management of adult patients with ascites caused by cirrhosis. Hepatology. 1998;27(1):264–272.PubMedCrossRef
3.
go back to reference Garcio-Tsao G, Sanyal A, Grace N, Carey W. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46(3):922–938.CrossRef Garcio-Tsao G, Sanyal A, Grace N, Carey W. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46(3):922–938.CrossRef
4.
5.
go back to reference Kaita K, Assy N, Gauthier T, Zhang M, Meyers A, Minuk G. The beneficial effects of a ciprofloxacin on survival and hepatic regenerative activity in a rat model of fulminant hepatic failure. Hepatology. 1998;27(2):533–536.PubMedCrossRef Kaita K, Assy N, Gauthier T, Zhang M, Meyers A, Minuk G. The beneficial effects of a ciprofloxacin on survival and hepatic regenerative activity in a rat model of fulminant hepatic failure. Hepatology. 1998;27(2):533–536.PubMedCrossRef
6.
go back to reference Minuk G, Gauthier T, Zhang X, Wang G, Burczynski F. Ciprofloxacin prevents the inhibitory effects of acute ethanol exposure on hepatic regeneration in the rat. Hepatology. 1995;22(6):1797–1800.PubMed Minuk G, Gauthier T, Zhang X, Wang G, Burczynski F. Ciprofloxacin prevents the inhibitory effects of acute ethanol exposure on hepatic regeneration in the rat. Hepatology. 1995;22(6):1797–1800.PubMed
7.
go back to reference Zhang M, Guopei S, Minuk G. Effects of hepatic stimulator substance, herbal medicine, selenium/vitamin E, and ciprofloxacin on cirrhosis in the rat. Gastroenterology. 1996;110(4):1150–1155.PubMedCrossRef Zhang M, Guopei S, Minuk G. Effects of hepatic stimulator substance, herbal medicine, selenium/vitamin E, and ciprofloxacin on cirrhosis in the rat. Gastroenterology. 1996;110(4):1150–1155.PubMedCrossRef
8.
go back to reference Minuk G, Gauthier T. The effect of gamma aminobutyric acid (GABA) on hepatic regenerative activity following partial hepatectomy in rats. Gastroenterology. 1993;104:217–221.PubMed Minuk G, Gauthier T. The effect of gamma aminobutyric acid (GABA) on hepatic regenerative activity following partial hepatectomy in rats. Gastroenterology. 1993;104:217–221.PubMed
9.
go back to reference Zhang M, Gong Y, Minuk G. The effects of ethanol and gamma aminobutyric acid alone and in combination on hepatic regenerative activity in the rat. J Hepatol. 1998;209:638–641.CrossRef Zhang M, Gong Y, Minuk G. The effects of ethanol and gamma aminobutyric acid alone and in combination on hepatic regenerative activity in the rat. J Hepatol. 1998;209:638–641.CrossRef
10.
go back to reference Rolachon A, Cordier L, Bacq Y, et al. Ciprofloxacin and long-term prevention of spontaneous bacterial peritonitis: results of a prospective controlled trial. Hepatology. 1995;22:1171–1174.PubMed Rolachon A, Cordier L, Bacq Y, et al. Ciprofloxacin and long-term prevention of spontaneous bacterial peritonitis: results of a prospective controlled trial. Hepatology. 1995;22:1171–1174.PubMed
11.
go back to reference Yang S, Wu C, Chiang T, Chen D. Somatosensory evoked potentials in subclinical portosystemic encephalopathy: a comparison with psychometric tests. Hepatology. 1998;27(2):357–361.PubMedCrossRef Yang S, Wu C, Chiang T, Chen D. Somatosensory evoked potentials in subclinical portosystemic encephalopathy: a comparison with psychometric tests. Hepatology. 1998;27(2):357–361.PubMedCrossRef
12.
go back to reference Ayling R. Pitfalls in the interpretation of common biochemical tests. Postgrad Med J. 2000;76(893):129–132.PubMedCrossRef Ayling R. Pitfalls in the interpretation of common biochemical tests. Postgrad Med J. 2000;76(893):129–132.PubMedCrossRef
13.
go back to reference Burke M. Liver function: tests selection and interpretation of results. Clin Lab Med. 2002;22(2):377–390.PubMedCrossRef Burke M. Liver function: tests selection and interpretation of results. Clin Lab Med. 2002;22(2):377–390.PubMedCrossRef
14.
go back to reference Gurbay A, Hincal F. Ciprofloxacin-induced glutathione redox status alterations in rat tissues. Drug Chem Toxicol. 2004;27(3):233–242.PubMedCrossRef Gurbay A, Hincal F. Ciprofloxacin-induced glutathione redox status alterations in rat tissues. Drug Chem Toxicol. 2004;27(3):233–242.PubMedCrossRef
15.
go back to reference Williams R. Review article: bacterial flora and pathogenesis in hepatic encephalopathy. Aliment Pharmacol Ther. 2007;25(Suppl 1):17–22.PubMedCrossRef Williams R. Review article: bacterial flora and pathogenesis in hepatic encephalopathy. Aliment Pharmacol Ther. 2007;25(Suppl 1):17–22.PubMedCrossRef
16.
go back to reference Freund HR, Muggia-Sullam M, LaFrance R, Enrione EB, Popp MB, Bjornson HS. A possible beneficial effect of metronidazole in reducing TPN-associated liver function derangements. J Surg Res. 1985;38(4):356–363.PubMedCrossRef Freund HR, Muggia-Sullam M, LaFrance R, Enrione EB, Popp MB, Bjornson HS. A possible beneficial effect of metronidazole in reducing TPN-associated liver function derangements. J Surg Res. 1985;38(4):356–363.PubMedCrossRef
17.
go back to reference Cornell RP, Liljequist BL, Bartizal KF. Depressed liver regeneration after partial hepatectomy of germ-free, athymic and lipopolysaccharide-resistant mice. Hepatology. 1990;11(6):916–922.PubMedCrossRef Cornell RP, Liljequist BL, Bartizal KF. Depressed liver regeneration after partial hepatectomy of germ-free, athymic and lipopolysaccharide-resistant mice. Hepatology. 1990;11(6):916–922.PubMedCrossRef
18.
go back to reference Segev S, Rehavi M, Rubinstein E. Quinolones, theophylline, and diclofenac interactions with the γ-aminobutyric acid receptor. Antimicrob Agents Chemother. 1988;32(11):1624–1626.PubMed Segev S, Rehavi M, Rubinstein E. Quinolones, theophylline, and diclofenac interactions with the γ-aminobutyric acid receptor. Antimicrob Agents Chemother. 1988;32(11):1624–1626.PubMed
19.
go back to reference Bass NM, Mullen KD, Sanyal A, et al. Rifaximin treatment in hepatic encephalopathy. N Engl J Med. 2010;362(12):1071–1081.PubMedCrossRef Bass NM, Mullen KD, Sanyal A, et al. Rifaximin treatment in hepatic encephalopathy. N Engl J Med. 2010;362(12):1071–1081.PubMedCrossRef
20.
go back to reference Montalito P, Viachogiannakos J, Cox D, Pastacaldi S, Patch D, Burroughs A. Bacterial infection in cirrhosis impairs coagulation by a heparin effect: a prospective study. J Hepatol. 2002;37(4):463–470.CrossRef Montalito P, Viachogiannakos J, Cox D, Pastacaldi S, Patch D, Burroughs A. Bacterial infection in cirrhosis impairs coagulation by a heparin effect: a prospective study. J Hepatol. 2002;37(4):463–470.CrossRef
21.
go back to reference Vlachogiannakos J, Saveriadis AS, Viazis N, et al. Intestinal decontamination improves liver haemodynamics in patients with alcohol-related decompensated cirrhosis. Aliment Pharmacol Ther. 2009;29(9):992–999.PubMedCrossRef Vlachogiannakos J, Saveriadis AS, Viazis N, et al. Intestinal decontamination improves liver haemodynamics in patients with alcohol-related decompensated cirrhosis. Aliment Pharmacol Ther. 2009;29(9):992–999.PubMedCrossRef
22.
go back to reference Fernandez J, Navasa M, Planas R, et al. Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis. Gastroenterology. 2007;133(3):818–824.PubMedCrossRef Fernandez J, Navasa M, Planas R, et al. Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis. Gastroenterology. 2007;133(3):818–824.PubMedCrossRef
23.
go back to reference Dexit R, Satapathy S, Kumar R, et al. Pharmacokinetics of ciprofloxacin in patients with liver cirrhosis. Indian H Gasteroenterol. 2004;21(2):62–63. Dexit R, Satapathy S, Kumar R, et al. Pharmacokinetics of ciprofloxacin in patients with liver cirrhosis. Indian H Gasteroenterol. 2004;21(2):62–63.
24.
go back to reference Schoof M, Hill K. Antibiotics for recurrent urinary tract infections. Am Fam Physician. 2005;71(7):1301–1302. Schoof M, Hill K. Antibiotics for recurrent urinary tract infections. Am Fam Physician. 2005;71(7):1301–1302.
25.
go back to reference Moyses Neto M, Costa R, Reis M, et al. Use of ciprofloxacin as a prophylactic agent in urinary tract infections in renal transplant recipients. Clin Transplant. 1997;11:446–452.PubMed Moyses Neto M, Costa R, Reis M, et al. Use of ciprofloxacin as a prophylactic agent in urinary tract infections in renal transplant recipients. Clin Transplant. 1997;11:446–452.PubMed
26.
go back to reference Weiss K. Clostridium difficile and fluoroquinolones: is there a link? Int J Antimicrob Agents. 2009;33(Suppl 1):S29–S32.PubMedCrossRef Weiss K. Clostridium difficile and fluoroquinolones: is there a link? Int J Antimicrob Agents. 2009;33(Suppl 1):S29–S32.PubMedCrossRef
Metadata
Title
Daily Ciprofloxacin Treatment for Patients with Advanced Liver Disease Awaiting Liver Transplantation Reduces Hospitalizations
Authors
G. Y. Minuk
K. Hawkins
K. D. E. Kaita
S. Wong
E. Renner
L. Minuk
J. Uhanova
Publication date
01-04-2011
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 4/2011
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-010-1456-2

Other articles of this Issue 4/2011

Digestive Diseases and Sciences 4/2011 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.