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Volume 152, Issue 5, Pages 1068-1077.e4 (April 2017)
In Patients With Severe Alcoholic Hepatitis, Prednisolone Increases Susceptibility to Infection and Infection-Related Mortality, and Is Associated With High Circulating Levels of Bacterial DNA Nikhil Vergis, Stephen R. Atkinson, Suzanne Knapp, James Maurice, Michael Allison, Andrew Austin, Ewan H. Forrest, Steven Masson, Anne McCune, David Patch, Paul Richardson, Dermot Gleeson, Stephen D. Ryder, Mark Wright, Mark R. Thursz Gastroenterology Volume 152, Issue 5, Pages e4 (April 2017) DOI: /j.gastro Copyright © 2017 AGA Institute Terms and Conditions
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Figure 1 Prescription of antibiotics significantly modulates the impact of baseline infection on 90-day mortality in prednisolone-treated patients. In all patients, no statistically significant impact of baseline sepsis on mortality is seen (A). In patients who present with infection and do not receive prednisolone, continuation of antibiotics alongside treatment for AH does not impact upon mortality (B), however, in patients who receive prednisolone concurrent antibiotic therapy significantly reduces mortality (C). Gastroenterology , e4DOI: ( /j.gastro ) Copyright © 2017 AGA Institute Terms and Conditions
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Figure 2 Early-onset infection leads to excess mortality in patients treated with prednisolone. In patients who do not develop infection within the first 7 days, there is a nonsustained improvement in mortality at 28 days (A). However, in patients who have early onset of infection, treatment with prednisolone is associated with a dramatic increase in mortality (B). Gastroenterology , e4DOI: ( /j.gastro ) Copyright © 2017 AGA Institute Terms and Conditions
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Figure 3 Comparison of survival curves to 90 days in patients with matched and high bDNA levels who were treated with prednisolone vs no prednisolone. Gastroenterology , e4DOI: ( /j.gastro ) Copyright © 2017 AGA Institute Terms and Conditions
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