Document Detail


Norfloxacin therapy for hepatopulmonary syndrome: a pilot randomized controlled trial.
MedLine Citation:
PMID:  20816858     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND & AIMS: The hepatopulmonary syndrome occurs in up to one-third of patients with cirrhosis. Animal models of this disease suggest that endotoxemia might cause nitric oxide-mediated vascular dilatation that can be inhibited by the antibiotic norfloxacin. We sought to test this hypothesis in humans.
METHODS: We conducted a pilot randomized, controlled crossover trial of norfloxacin 400 mg twice daily for 4 weeks with a 4-week washout period to assess the feasibility of a larger trial. The primary clinical end point was change in alveolar-arterial oxygen gradient (AaDO₂).
RESULTS: Recruitment was challenging, and change in AaDO₂ was highly variable. We recruited 9 adults (1 woman; age, 60 ± 9 years; AaDO₂, 50 ± 22 mm Hg). AaDO₂ decreased by 0.8 ± 4.8 and 3.4 ± 12.4 mm Hg while on norfloxacin and placebo, respectively (P = .59).
CONCLUSIONS: Recruitment difficulties and variability of the primary outcome measure suggest the need for a multicenter clinical research network for future therapeutic trials in this disease. There was no major effect of norfloxacin on gas exchange in patients with hepatopulmonary syndrome.
Authors:
Samir Gupta; Marie E Faughnan; Les Lilly; Stuart Hutchison; Robert Fowler; Ahmed M Bayoumi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-09
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  8     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1095-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, University of Toronto, Ontario, Canada. guptas@smh.toronto.on.ca
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