Patient Outcomes in Mesenteric Venous Thrombosis Treated With Empiric Antibiotics

Area of Science:

• Gastroenterology
• Vascular Surgery
• Infectious Diseases

Background:

• Mesenteric venous thrombosis (MVT) is a serious condition often linked to poor patient outcomes.
• The use of prophylactic antibiotics in MVT management is debated, aiming to reduce bacterial translocation.
• Evidence supporting empiric antibiotic use in MVT is limited, prompting further investigation into its efficacy and risks.

Purpose of the Study:

• To evaluate the impact of empiric antibiotic administration on patient outcomes in Mesenteric Venous Thrombosis (MVT).
• To compare mortality rates, need for bowel resection, hospital readmissions, and Clostridium difficile infections between MVT patients who received empiric antibiotics and those who did not.

Main Methods:

• A retrospective analysis was conducted on 83 patients diagnosed with MVT between 2002 and 2019.
• Patients were divided into two groups: those treated with empiric antibiotics and those receiving supportive care without antibiotics.
• Key outcomes including mortality, bowel resection, readmission, and Clostridium difficile infection rates were compared.

Main Results:

• Of 83 MVT patients, 53% received empiric antibiotics. Mortality rates were 9.1% with antibiotics versus 15.3% without (P = .50).
• Readmission rates were similar: 27.3% for antibiotic group vs. 25.6% for non-antibiotic group (P = .87).
• Clostridium difficile infections occurred in 13.6% of patients receiving antibiotics, compared to 0% in the non-antibiotic group (P = .03).

Conclusions:

• Empiric antibiotic use in Mesenteric Venous Thrombosis (MVT) does not appear to enhance survival or decrease hospital readmissions.
• The findings suggest that empiric antibiotics may increase the risk of Clostridium difficile infections in MVT patients.
• Current evidence does not support routine empiric antibiotic administration for MVT management due to potential harm and lack of demonstrated benefit.