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Oral Antibiotics Reduce Intestinal Necrosis in Acute Mesenteric Ischemia

A Prospective Cohort Study

Nuzzo, Alexandre, MD1,11; Maggiori, Leon, MD, PhD2,11; Paugam-Burtz, Catherine, MD, PhD3,11; Cazals-Hatem, Dominique, MD4,11; Ronot, Maxime, MD, PhD5,11; Huguet, Audrey, MD1,11; Becq, Aymeric, MD1; Castier, Yves, MD, PhD6; Weiss, Emmanuel, MD3,11; Plessier, Aurélie, MD7,11; Tran-Dinh, Alexy, MD, PhD8; Joly, Francisca, MD, PhD1,11; Panis, Yves, MD, PhD2,11; Bouhnik, Yoram, MD, PhD1,11; Gault, Nathalie, MD, PhD9,10,11; Corcos, Olivier, MD1,11

American Journal of Gastroenterology: February 2019 - Volume 114 - Issue 2 - p 348–351
doi: 10.1038/s41395-018-0389-9
BRIEF COMMUNICATIONS

OBJECTIVES: To identify treatments likely to prevent progression towards irreversible transmural intestinal necrosis (ITIN) in acute mesenteric ischemia (AMI).

METHODS: Prospective observational cohort study from a French intestinal stroke center. Multivariate analysis using a time-dependent Cox regression model.

RESULTS: Between 2009 and 2015, 67 patients with AMI were included. ITIN occurred in 34% of patients and mortality was 13%. Oral antibiotics was independently associated with a decreased risk of ITIN (HR: 0.16 (95% CI = 0.03–0.62); p = 0.01).

CONCLUSIONS: By decreasing luminal bacterial load and translocation, oral antibiotics in addition to early revascularization might reduce progression of AMI to ITIN.

1APHP, Department of Gastroenterology, IBD and Intestinal Failure, Beaujon Hospital, 92110, Clichy, France;

2APHP, Department of Colorectal Surgery, Beaujon Hospital, 92110, Clichy, France;

3APHP, Department of Anesthesia and Intensive Care, Beaujon Hospital, 92110, Clichy, France;

4APHP, Department of Surgery, Bichat Hospital, 75018, Paris, France;

5APHP, Department of Radiology, Beaujon Hospital, 92110, Clichy, France;

6APHP, Department of Vascular Surgery, Bichat Hospital, 75018, Pairs, France;

7APHP, Department of Hepatology, Beaujon Hospital, 92110, Clichy, France;

8APHP, Department of Surgical France;

9APHP, Department of Epidemiology, Biostatistics and Clinical Research, Bichat Hospital, 75018, Paris, France;

10INSERM CIC-EC 1425, Bichat Hospital, 75018, Paris, France;

11DHU Unity, Paris 7 Diderot university, Sorbonne Paris Cite, 75013, Paris, France.

Correspondence: Alexandre Nuzzo, MD. E-mail: al.nuzzo@gmail.com.

These authors contributed equally: Alexandre Nuzzo, Leon Maggiori.

Received June 02, 2018

Accepted September 25, 2018

© The American College of Gastroenterology 2019. All Rights Reserved.
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