Quality standard
Quality statement 6: Prophylactic antibiotic therapy for variceal bleeding
Quality statement 6: Prophylactic antibiotic therapy for variceal bleeding
Quality statement
People with suspected or confirmed variceal acute upper gastrointestinal bleeding are given antibiotic therapy at presentation.
Rationale
People with variceal acute upper gastrointestinal bleeding are prone to infection. Infection has adverse effects on renal function and commonly precipitates hepatorenal failure, characterised by oliguria, sodium and fluid retention and death. Early antibiotic therapy reduces these risks.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that people with suspected or confirmed variceal acute upper gastrointestinal bleeding are given antibiotic therapy at presentation.
Data source: Local data collection.
Process
Proportion of people with suspected or confirmed variceal acute upper gastrointestinal bleeding who receive antibiotic therapy at presentation.
Numerator – the number of people in the denominator who receive antibiotic therapy at presentation.
Denominator – the number of people with suspected or confirmed variceal acute upper gastrointestinal bleeding at presentation.
Data source: Local data collection.
What the quality statement means for different audiences
Service providers ensure that systems are in place for people with suspected or confirmed variceal acute upper gastrointestinal bleeding to be given antibiotic therapy at presentation.
Healthcare practitioners give antibiotic therapy at presentation to people with suspected or confirmed variceal acute upper gastrointestinal bleeding.
Commissioners ensure that they commission services that give antibiotic therapy at presentation to people with suspected or confirmed variceal acute upper gastrointestinal bleeding.
People with acute upper gastrointestinal bleeding known or suspected to be caused by enlarged veins are given antibiotics when they first see a healthcare professional.
Source guidance
Acute upper gastrointestinal bleeding in over 16s: management. NICE guideline CG141 (2012, updated 2016), recommendation 1.5.2 (key priority for implementation)