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Beta‐blockers in patients with cirrhosis and infections: don't blame too soon!
Author(s) -
Merli Manuela,
Lucidi Cristina,
Venditti Mario,
Riggio Oliviero
Publication year - 2015
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12812
Subject(s) - medicine , cirrhosis , gastroenterology , blame , psychiatry
We found that PPI-users had a higher rate and BBs-users a lower rate of infections. The lower infection rate and better prognosis of BB-users can not be attributed, as suggested by Schiavon et al., to a higher proportion of variceal bleeding in this group; in fact, the large majority of patients hospitalized for bleeding were excluded from the study as they came to our ward already on systemic antibiotic treatment (which is usually started in the Emergency room) and this would have represented a confounding factor. Only few patients with variceal bleeding were included: they developed bleeding after enrolment and were equally distributed between those taking and not taking BBs. Following the recent debate about the ‘therapeutic window’ of BBs in cirrhotic patients (2–4), we were also interested in evaluating possible harmful effects of BBs in cirrhotic patients with infections. This was a secondary aim of our study and we certainly recognize that the study was underpowered for this purpose