206, 0.301, −0.504, 0.425 respectively, p≤0.001). Finally, ARFI was not significantly correlated with hepatic inflammation level as measured by ALT (p = 0.182) and BMI (p = 0.163). Conclusion: Acoustic radiation force impulse imaging provides reliable and accurate assessment of hepatic fibrosis and is well correlated with the established non-invasive transient elastography. Further strength of this technology EGFR inhibitor resides with absence of influence by hepatic inflammation and BMI, in addition to the ability of providing concurrent conventional ultrasonographic assessment. This combined approach in the hands of trained gastroenterologist may have substantial advantages for delivering efficient

clinical service to these patients. P SUNDARALINGAM, WC TEOH, IB TURNER Department of Gastroenterology, Campbelltown Hospital, NSW University of Western Sydney, Campbelltown, NSW Background: Bacterial infections in the cirrhotic patient are a frequent and leading cause of mortality. Appropriate antibiotic prophylaxis can significantly reduce the incidence of infections BAY 57-1293 solubility dmso in cirrhotics however data on rates of implementation of appropriate prophylaxis is lacking. Saab et al (Journal of Clinical Gastroenterology 2006 Feb;40(2):156–61) suggested that prophylaxis utilization is low. The aim of this study was to determine the rate of prophylactic antibiotic usage in cirrhotic patients

at an outer metropolitan teaching hospital in NSW. Methods: Medical record data of cirrhotic patients admitted to Campbelltown Hospital between April 2011 and March 2013 was collected retrospectively. The data was analyzed to identify patients who were eligible for antibiotic prophylaxis. Specific groups evaluated were: 1) acute upper gastrointestinal haemorrhage 2) spontaneous Vorinostat bacterial peritonitis and 3) high SBP risk (low protein ascites and advanced liver disease). The records of these patients were reviewed to evaluate whether prophylactic antibiotic usage was in accordance with guidelines endorsed by AASLD and EASL. Results: 107 patients with cirrhosis had 193 admissions during the 2-year study period. (1) There were 24 admissions (19 patients) for upper gastrointestinal

bleeding. Appropriate antibiotic therapy was instituted in 20/24 bleeding episodes. In all but two instances, antibiotics were initiated on the first day of admission and prior to endoscopic intervention. The average duration of antibiotic usage was only 2.9 days (recommended duration 5- 7 days). Infection did not complicate the hospital stay of any patient that received antibiotic prophylaxis; both deaths in this group were a result of uncontrolled bleeding. Of the 4 patients who did not receive antibiotics, 2 died from uncontrolled haemorrhage. Infection did not complicate the hospital stay of the remaining 2 patients. (2) There were only 3 admissions (2 patients) with spontaneous bacterial peritonitis defined by an ascitic PMN count of > 250 cells/mm3.