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Contributions

Selective bowel decontamination with quinolones and nystatin reduces gram-negative and fungal infections in orthotopic liver transplant recipients

Margaret J. Gorensek, MD, William D. Carey, MD, John A. Washington, MD, David P. Vogt, MD, Thomas A. Broughan, MD and Mary Kay Westveer, RN
Cleveland Clinic Journal of Medicine March 1993, 60 (2) 139-144;
Margaret J. Gorensek
Department of Infectious Diseases, Cleveland Clinic Florida
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William D. Carey
Department of Gastroenterology, The Cleveland Clinic Foundation, Cleveland.
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John A. Washington II
Department of Microbiology, The Cleveland Clinic Foundation, Cleveland.
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David P. Vogt
Department of General Surgery, The Cleveland Clinic Foundation, Cleveland.
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Thomas A. Broughan
Department of General Surgery, The Cleveland Clinic Foundation, Cleveland.
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Mary Kay Westveer
Department of Gastroenterology, The Cleveland Clinic Foundation, Cleveland.
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ABSTRACT

Gram-negative and fungal infections are the most important cause of morbidity and mortality after liver transplantation, especially in the first postoperative month. From February 1989 to February 1990, all liver transplant recipients at The Cleveland Clinic Foundation, Cleveland, Ohio, were placed on a selective bowel decontamination regimen employing oral quinolones and nystatin beginning at the time they were put on the active waiting list for transplantation and continuing until the fourth postoperative week. The incidence of gram-negative and fungal infections for these patients was compared against a historical control group. Selective bowel decontamination was well tolerated and highly effective in reducing early serious gram-negative and fungal infections. This regimen may also reduce mortality.

INDEX TERMS
  • Liver Transplantation
  • Decontamination
  • Anti-Infective Agents
  • Quinolone
  • Nystatin
  • Gram-Negative Bacteria
  • Mycoses
  • Copyright © 1993 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 60 (2)
Cleveland Clinic Journal of Medicine
Vol. 60, Issue 2
1 Mar 1993
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Selective bowel decontamination with quinolones and nystatin reduces gram-negative and fungal infections in orthotopic liver transplant recipients
Margaret J. Gorensek, William D. Carey, John A. Washington, David P. Vogt, Thomas A. Broughan, Mary Kay Westveer
Cleveland Clinic Journal of Medicine Mar 1993, 60 (2) 139-144;

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Selective bowel decontamination with quinolones and nystatin reduces gram-negative and fungal infections in orthotopic liver transplant recipients
Margaret J. Gorensek, William D. Carey, John A. Washington, David P. Vogt, Thomas A. Broughan, Mary Kay Westveer
Cleveland Clinic Journal of Medicine Mar 1993, 60 (2) 139-144;
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Keywords

  • Liver Transplantation
  • Decontamination
  • Anti-Infective Agents
  • Quinolone
  • Nystatin
  • Gram-Negative Bacteria
  • Mycoses

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