Publication

Abstract : The aims of the present study 1)to determine the frequency of sepsis as precipitating factor for HE 2) evaluate the effectiveness of antibiotic therapy in SAE (Sepsis associated encephalopathy) and to determine the outcome of management.3) To study the effectiveness of secondary prophylactic antibiotic therapy. Prospective observational study of 150 patients who are diagnosed with cirrhosis complicated with hepatic encephalopathy. All the patients satisfying the inclusion and exclusion criteria were selected for the study and relevant data were collected. Antibiotics were assessed for appropriateness according to type, time, dose and frequency. The antibiotic prescribed was deemed to be appropriate if it was prescribed according to the microbial susceptibility data whereas it was inappropriate if it did not reflect the susceptibility data. If the antibiotic is not administered within 24hr after the culture and sensitivity report is considered as inappropriate. Outcome is measured with respect to the death or survival of patients. A total of 150 patients were enrolled in the study. Sepsis (55.3%) was the common precipitating factor for all patients with cirrhosis to develop hepatic encephalopathy. Antibiotic therapy was inappropriate (57.8%) in patients due to incorrect type, dose and frequency. There was a significant association between patient outcome (P=<0.001) and inappropriateness of antibiotics. Severity of sepsis was a strong prognostic factor of mortality. Mortality from HE is likely to decrease due to early diagnosis and appropriate use of antibiotics. These results emphasize the importance of providing appropriate antibiotics for treating infection.