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Long-term antibiotics and PPI's induce bacterial translocation in patients with cirrhosis: antibiotics are not always ANTI-biotics.

O’Leary JG, Reddy KR, Wong F, et al. Long-term use of antibiotics and proton-pump inhibitors predict development of infections in patients with cirrhosis. Clin Gastroenterol Hepatol 2014; pii: S1542-3565(14)01146X. doi: 10.1016/j.cgh.2014.07.060. [Epub ahead of print]. O’Leary et al. (1) prospectively analyzed 188 patients with cirrhosis who were hospitalized for infection from 12 centers (North American Consortium for the Study of End-Stage Liver Disease). They investigated and characterized risk factors for repeat infections in these patients. Patients were followed for 6 months after hospital discharge and data were analyzed on type of infections and factors associated with subsequent infections. Just after 6 months after hospital discharge, only 59% of them were alive and 14% had liver transplant.