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- W2030894003 abstract "Sirs, We would like to thank the authors for their interest in our study.1, 2 Although we agree that our results are preliminary, we believe that our data give further evidence that bacteria and bacterial products deteriorate liver haemodynamics in cirrhotics. It is true that a placebo group is lacking from our study, but our data strongly support the efficacy of antibiotics in reducing HVPG. The beneficial role of intestinal decontamination is also supported by the significant reduction in endotoxin levels that was directly correlated with the drop in HVPG. Furthermore, it is worth noting that instead of norfloxacin, for the first time, we used rifaximin - a highly efficient and safe antibiotic with a broad spectrum of action and minimal intestinal absorption. We believe that our results could not have been biased by other factors, like for example, continued alcohol consumption, as all our patients were regularly followed-up at the outpatient clinic, where they had prolonged periods of documented alcohol abstinence. As regards follow-up data on the outcome of our study population during the study period, it should be mentioned that all our patients were alive at the end of the 28 days. Regular admissions were necessary for endoscopic ligation of the varices in six patients and treatment of ascites in three patients. The authors comment on the two previous studies that found no advantage of norfloxacin over placebo in reducing HVPG; however, the results of these studies have to be viewed with skepticism, as they have included a small number of patients with various aetiologies of cirrhosis.3, 4 Finally, we agree that our data support the need for additional studies, which would further investigate the efficacy of long-term antibiotic administration in the prevention of portal hypertension complications. Declaration of personal and funding interests: None." @default.
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- W2030894003 date "2009-08-01" @default.
- W2030894003 modified "2023-09-24" @default.
- W2030894003 title "Does debugging the portal system decrease pressure? Authors’ reply" @default.
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- W2030894003 doi "https://doi.org/10.1111/j.1365-2036.2009.04046.x" @default.
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