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Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind study

dc.contributor.authorRomeiro, Fernando Gomes [UNESP]
dc.contributor.authorda Silva Yamashiro, Fabio [UNESP]
dc.contributor.authorAmérico, Madileine Francely
dc.contributor.authorCorá, Luciana Aparecida
dc.contributor.authorSilva, Giovanni Faria [UNESP]
dc.contributor.authorMiranda, JoséRicardodeArruda [UNESP]
dc.contributor.authorCaramori, Carlos Antonio [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionUniversidade Federal de Mato Grosso (UFMT)
dc.contributor.institutionUniversidade Estadual de Ciências da Saúde de Alagoas (UNCISAL)
dc.date.accessioned2014-05-27T11:28:10Z
dc.date.available2014-05-27T11:28:10Z
dc.date.issued2013-01-16
dc.description.abstractBackground: Hepatic encephalopathy (HE) is a severe complication in patients with hepatic cirrhosis, which causes numerous hospital admissions and deaths. Antibiotics are the best options in HE treatment, but head-to-head comparisons between these drugs are scarce. Erythromycin combines the antimicrobial effect and prokinetic properties in the same drug, but it has never been used in HE treatment. Our aim was to evaluate the efficacy of erythromycin as an HE treatment.Methods: We achieved a randomized controlled trial of adult patients with HE and hepatic cirrhosis admitted in our hospital. After randomization, the subjects received either erythromycin 250 mg or neomycin 1 g orally QID until hospital discharge or prescription of another antibiotic. All subjects were blindly evaluated every day towards quantifying clinical, neuropsychometric, hepatic and renal exams. Statistical analysis was employed to compare the groups and correlate the variables with hospitalization duration.Results: 30 patients were evaluated (15 treated with each drug). At hospital admission, the groups were homogeneous, but the erythromycin group subjects achieved a shorter hospitalization stay (p = 0.032) and a more expressive reduction in alanine aminotranspherase levels (p = 0.026). Hospitalization duration was positively correlated with C reactive protein levels measured previous to (p = 0.015) and after treatment (p = 0.01).Conclusions: In the sample evaluated erythromycin was associated with significant reductions in hospital stay and in alanine aminotranspherase values. Hospitalization time was positive correlated with C reactive protein levels measured before and after the treatments. © 2013 Romeiro et al.; licensee BioMed Central Ltd.en
dc.description.affiliationDepartment of Internal Medicine Faculdade de Medicina de Botucatu UNESP - Universidade Estadual Paulista, Botucatu
dc.description.affiliationBiological and Health Sciences Institute Campus Médio Araguaia UFMT -Universidade Federal do Mato Grosso, Barra do Garças
dc.description.affiliationHealth Sciences Center UNCISAL - Universidade Estadual de Ciências da Saúde de Alagoas, Maceió
dc.description.affiliationDepartment of Physics and Biophysics Instituto de Biociências de Botucatu UNESP - Universidade Estadual Paulista, Botucatu
dc.description.affiliationDepartment of Internal Medicine - Botucatu Medical School UNESP- Universidade Estadual Paulista, Distrito de Rubião Jr. s/n zip code 18 608 917, Botucatu, São Paulo
dc.description.affiliationUnespDepartment of Internal Medicine Faculdade de Medicina de Botucatu UNESP - Universidade Estadual Paulista, Botucatu
dc.description.affiliationUnespDepartment of Physics and Biophysics Instituto de Biociências de Botucatu UNESP - Universidade Estadual Paulista, Botucatu
dc.description.affiliationUnespDepartment of Internal Medicine - Botucatu Medical School UNESP- Universidade Estadual Paulista, Distrito de Rubião Jr. s/n zip code 18 608 917, Botucatu, São Paulo
dc.identifierhttp://dx.doi.org/10.1186/1471-230X-13-13
dc.identifier.citationBMC Gastroenterology, v. 13, n. 1, 2013.
dc.identifier.doi10.1186/1471-230X-13-13
dc.identifier.file2-s2.0-84872204045.pdf
dc.identifier.issn1471-230X
dc.identifier.lattes6322604200510676
dc.identifier.lattes5518720125698768
dc.identifier.scopus2-s2.0-84872204045
dc.identifier.urihttp://hdl.handle.net/11449/74385
dc.identifier.wosWOS:000314062300001
dc.language.isoeng
dc.relation.ispartofBMC Gastroenterology
dc.relation.ispartofjcr2.731
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectErythromycin
dc.subjectHepatic encephalopathy
dc.subjectLiver cirrhosis
dc.subjectNeomycin
dc.subjectalanine aminotransferase
dc.subjectantibiotic agent
dc.subjectC reactive protein
dc.subjecterythromycin
dc.subjecterythromycin estolate
dc.subjectneomycin
dc.subjectadult
dc.subjectalanine aminotransferase blood level
dc.subjectantibiotic therapy
dc.subjectclinical article
dc.subjectclinical evaluation
dc.subjectclinical examination
dc.subjectcontrolled study
dc.subjectdouble blind procedure
dc.subjectdrug efficacy
dc.subjectfemale
dc.subjecthepatic encephalopathy
dc.subjecthospital admission
dc.subjecthospital discharge
dc.subjecthospitalization
dc.subjecthuman
dc.subjectkidney examination
dc.subjectlength of stay
dc.subjectliver cirrhosis
dc.subjectliver examination
dc.subjectmale
dc.subjectneuropsychological test
dc.subjectprescription
dc.subjectprotein blood level
dc.subjectquantitative analysis
dc.subjectrandomization
dc.subjectrandomized controlled trial
dc.subjecttreatment response
dc.subjectAdministration, Oral
dc.subjectAdult
dc.subjectAged
dc.subjectAlanine Transaminase
dc.subjectAnti-Bacterial Agents
dc.subjectC-Reactive Protein
dc.subjectDose-Response Relationship, Drug
dc.subjectDouble-Blind Method
dc.subjectFemale
dc.subjectHepatic Encephalopathy
dc.subjectHumans
dc.subjectLength of Stay
dc.subjectLiver Cirrhosis
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectTreatment Outcome
dc.titleErythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: A randomized double-blind studyen
dc.typeArtigo
dcterms.licensehttp://www.biomedcentral.com/about/license
dspace.entity.typePublication
unesp.author.lattes6322604200510676
unesp.author.lattes5518720125698768[7]
unesp.author.orcid0000-0002-0390-1061[7]
unesp.author.orcid0000-0002-8306-8056[6]
unesp.campusUniversidade Estadual Paulista (UNESP), Instituto de Biociências, Botucatupt
unesp.campusUniversidade Estadual Paulista (UNESP), Faculdade de Medicina, Botucatupt
unesp.departmentClínica Médica - FMBpt
unesp.departmentFísica e Biofísica - IBBpt

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