Evidence map›Paper›PMID 37171554›Full record

ArticleJournal of gastroenterology2023

Real-world efficacy of antibiotic prophylaxis for upper gastrointestinal bleeding in cirrhotic patients in Japan.

Masayuki Ueno, Takashi Fujiwara, Hironobu Tokumasu, Toshifumi Mano, Takahisa Kayahara, Hiroyuki Takabatake, Youichi Morimoto, Kazuhiro Matsueda, Toshio Fukuoka, Motowo Mizuno

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In one paragraph

Article in Journal of gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Evidence for preventing EVRB in cirrhotic patients: A systematic review.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2025
    Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Masayuki UenoDepartment of Gastroenterology and Hepatology, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama, 710-8602, Japan. masayukiu@kuhp.kyoto-u.ac.jp.ORCID http://orcid.org/0000-0002-2497-9327
Takashi FujiwaraDepartment of Public Health Research, Kurashiki Clinical Research Institute, Okayama, Japan.
Hironobu TokumasuDepartment of Public Health Research, Kurashiki Clinical Research Institute, Okayama, Japan.
Toshifumi ManoDepartment of Gastroenterology and Hepatology, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama, 710-8602, Japan.
Takahisa KayaharaDepartment of Gastroenterology and Hepatology, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama, 710-8602, Japan.
Hiroyuki TakabatakeDepartment of Gastroenterology and Hepatology, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama, 710-8602, Japan.
Youichi MorimotoDepartment of Gastroenterology and Hepatology, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama, 710-8602, Japan.
Kazuhiro MatsuedaDepartment of Gastroenterology and Hepatology, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama, 710-8602, Japan.
Toshio FukuokaEmergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan.
Motowo MizunoDepartment of Gastroenterology and Hepatology, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama, 710-8602, Japan.
Kurashiki Central Hospital · JPKyoto University · JP

Funding

Japan Agency for Medical Research and Development 20IA1012
6 · The paper itself

Abstract

BACKGROUND AND

aimsAntibiotic prophylaxis is recommended for cirrhotic patients with upper gastrointestinal bleeding (UGIB). However, the frequency of bacterial infection in such patients has remarkably decreased over the decades, which has reduced the necessity for prophylaxis. Therefore, here we investigated the real-world adherence and effectiveness of antibiotic prophylaxis in cirrhotic patients with UGIB in Japan.

methodsThis population-based study was conducted with a Japanese real-world database of the Health, Clinic, and Education Information Evaluation Institute. We enrolled cirrhotic patients who were hospitalized for UGIB between April 2010 and March 2020. After those who died within 24 h and who had aspiration pneumonia at admission were excluded, 1232 patients were analyzed. Rates of 6-week mortality, in-hospital bacterial infection, 30-day readmission, and length of hospital stay were evaluated.

resultsProphylactic antibiotics were prescribed in 142 (11.5%) patients. Multivariate analysis revealed that antibiotic prophylaxis was not significantly associated with either 6-week mortality or bacterial infection. After propensity score matching, the rates of 6-week mortality (7.2% vs. 8.4%, P = 0.810), bacterial infection (9.6% vs. 4.2%, P = 0.082), and 30-day unexpected readmission (7.2% vs. 7.8%, P = 1.000) were similar in patients with and without prophylaxis, whereas the median length of hospital stay was significantly longer in patients with prophylaxis (17 days vs. 13 days, P = 0.013).

conclusionsUnder current real-world circumstances in Japan, prophylactic antibiotics were prescribed in only 11.5% of cirrhotic patients with UGIB and were not associated with better clinical outcomes.

Indexed as

Antibiotic ProphylaxisBacterial InfectionsAnti-Bacterial AgentsGastrointestinal HemorrhageHumansJapanLiver CirrhosisAnti-Bacterial AgentsAntimicrobial prophylaxisLiver cirrhosisLiver failureUpper gastrointestinal hemorrhage

Identifiers

PMID37171554
OpenAlexW4376226451

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.