Abstract
Although antimicrobial therapy is recommended for patients with moderate or severe ischemic colitis, its beneficial effects are unclear. In the present study, the role of antimicrobial therapy in the treatment of ischemic colitis was investigated. Patients with ischemic colitis were retrospectively identified between January 2004 and June 2019. The characteristics and outcomes of patients who received antibiotics (antibiotics group) and those who did not (no-antibiotics group) were compared. Clinical outcomes included death, surgery, and readmission within 30 days, fasting duration, and hospital stay. Data from 186 patients were analyzed; 122 patients were in the antibiotics group and 64 in the no-antibiotics group. Composite outcome of death, surgery, and readmission within 30 days occurred in 3.3% of patients in the antibiotics group and 3.1% of patients in the no-antibiotics group (p > 0.999). Fasting duration was not significantly different between the two groups (median days, 4.0 vs. 4.0, p = 0.253). However, hospital stays were longer in the antibiotics group than in the no-antibiotics group (median days, 9.0 vs. 7.0, p = 0.043). In patients with ischemic colitis, there was no statistically significant difference in the incidence of death, surgery, and readmission within 30 days between patients who received antibiotics and those who did not receive antibiotics.
Highlights
Ischemic colitis is the most common form of gastrointestinal ischemia, which results from transient alterations of the mesenteric blood flow [1,2]
The number of risk factors and disease distribution were identified as factors associated with the length of hospital stay
We confirmed that patients with ischemic colitis who had no acute indication of surgery at presentation had an excellent prognosis
Summary
Ischemic colitis is the most common form of gastrointestinal ischemia, which results from transient alterations of the mesenteric blood flow [1,2]. The incidence of ischemic colitis is reportedly 16.3 cases per 100,000 person-years in a recent population-based study and comprises the major cause of hospitalization for acute lower gastrointestinal bleeding [3,4]. Ischemic colitis involves a wide variety of clinical spectra, ranging from transient or reversible ischemia that resolves spontaneously to fulminant colitis that may cause death [2]. The majority of patients with ischemic colitis improve with only conservative treatment, including bowel rest, intravenous hydration, and correction of electrolyte imbalance [2]. Patients with peritoneal signs, massive bleeding, or fulminant colitis require surgical treatment, leading to high morbidity and mortality [5]
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