Antibiotic Prophylaxis for Patients with Cirrhosis and Upper Gastrointestinal Bleeding

Professional societies recommend antibiotic prophylaxis for 5 days following upper gastrointestinal bleeding (UGIB) in patients with cirrhosis (Hepatology 2024; 79:1180). However, this recommendation was based on trials conducted before widespread use of vasoactive medications, restrictive transfusions, and endoscopic and endovascular therapies, which have improved outcomes. To evaluate whether antibiotics still are beneficial for these patients, researchers conducted a meta-analysis of 14 randomized trials (12 unblinded; 1300 patients with cirrhosis and UGIB, including 90% with variceal hemorrhages) and compared outcomes between patients who received any antibiotic prophylaxis versus none and between patients who received longer (5–7 days)…