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A few days ago Dr. Jump and I had a case of an acute variceal hemorrhage. Dr. Bond already sent out a great pearl earlier in the year highlighting the importance of octreotide in acute variceal bleeding. In fact, octreotide alone can result in cessation of hemorrhage in up to 80% of patients. To add onto Dr. Bond's pearl:
- Don't forget about antibiotics in acute variceal hemorrhage
- These patients have a relatively high incidence of bacteremia, which leads to worse outcomes
- Antibiotics have been shown to decrease infection rates and are associated with decreased rebleeding and the need for transfusions
- A 3rd generation cephalosporin is currently the recommended antibiotic of choice