IS PARENTERAL NUTRITION-RELATED CHOLESTAT IC LIVER-DISEASE AN INFECTIOUS-DISEASE

The aim of this retrospective study was fo determine whether total par enteral nutrition-related liver disease was improved by intravenous an tibiotics given for systemic sepsis. Liver function tests were perform ed I month before, during and I month after one episode of sepsis trea ted for 4 weeks (mean, range: 2-12), with systemic antibiotics, in 12 patients receiving parenteral nutrition for 13 months (mean, range: 1- 71) for short bowel syndrome in 10 of them. Cholestatic liver disease appeared in all during nutrition (mean serum alkaline phosphatase acti vity > 4 NJ. Liver test abnormalities observed at the beginning of ant ibiotics treatment were not significantly different from those observe d I month before sepsis. Antibiotic administration was followed by a s ignificant decrease (P less than or equal to 0.03) in serum activities of alkaline phosphatases, ALT and AST and bilirubinemia of 38, 41, 23 and 47 %, respectively. These results support the concept that parent eral nutrition-associated cholestatic liver disease may be related to intestinal bacterial overgrowth and suggest that if may be improved by intravenous antibiotherapy.