Spontaneous bacterial peritonitis primary prevention: Difference between revisions
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* Prevention of [[peritonitis]] in cases of [[ascites]]. | * Prevention of [[peritonitis]] in cases of [[ascites]]. | ||
* Intravenous [[ceftriaxone]] for 7 days or twice-daily norfloxacin for 7 days should be given to prevent [[bacterial infections]] in patients with [[cirrhosis]] and [[gastrointestinal hemorrhage]]. <ref name="pmid12076458">{{cite journal |author=Soares-Weiser K, Brezis M, Tur-Kaspa R, Leibovici L |title=Antibiotic prophylaxis for cirrhotic patients with gastrointestinal bleeding |journal=Cochrane database of systematic reviews (Online) |volume= |issue=2 |pages=CD002907 |year=2002 |pmid=12076458 |doi=}}</ref> | * Intravenous [[ceftriaxone]] for 7 days or twice-daily norfloxacin for 7 days should be given to prevent [[bacterial infections]] in patients with [[cirrhosis]] and [[gastrointestinal hemorrhage]]. <ref name="pmid12076458">{{cite journal |author=Soares-Weiser K, Brezis M, Tur-Kaspa R, Leibovici L |title=Antibiotic prophylaxis for cirrhotic patients with gastrointestinal bleeding |journal=Cochrane database of systematic reviews (Online) |volume= |issue=2 |pages=CD002907 |year=2002 |pmid=12076458 |doi=}}</ref> | ||
*Patients with cirrhosis and ascites but no gastrointestinal hemorrhage, long-term use of [[norfloxacin]] can be considered if the ascitic fluid protein <1.5 g/dL and one or more of the following are present: serum creatinine >1.2 mg/dL, blood urea nitrogen >25 mg/dL, serum sodium <130 mEq/L or Child-Pugh >9 points with bilirubin >3 mg/dL.<ref name="pmid17854593">{{cite journal| author=Fernández J, Navasa M, Planas R, Montoliu S, Monfort D, Soriano G et al.| title=Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis. | journal=Gastroenterology | year= 2007 | volume= 133 | issue= 3 | pages= 818-24 | pmid=17854593 | doi=10.1053/j.gastro.2007.06.065 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17854593 }} </ref><ref name="pmid9049193">{{cite journal| author=Novella M, Solà R, Soriano G, Andreu M, Gana J, Ortiz J et al.| title=Continuous versus inpatient prophylaxis of the first episode of spontaneous bacterial peritonitis with norfloxacin. | journal=Hepatology | year= 1997 | volume= 25 | issue= 3 | pages= 532-6 | pmid=9049193 | doi=10.1002/hep.510250306 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9049193 }} </ref> | |||
* Intermittent dosing of antibiotics to prevent bacterial infections may be inferior to daily dosing (due to the development of bacterial resistance) and thus daily dosing should preferentially be used. <ref name="urlNational Guideline Clearinghouse | Management of adult patients with ascites due to cirrhosis: an update.">{{cite web |url=http://guideline.gov/content.aspx?id=14887&search=ascitis |title=National Guideline Clearinghouse | Management of adult patients with ascites due to cirrhosis: an update. |format= |work= |accessdate=}}</ref> | * Intermittent dosing of antibiotics to prevent bacterial infections may be inferior to daily dosing (due to the development of bacterial resistance) and thus daily dosing should preferentially be used. <ref name="urlNational Guideline Clearinghouse | Management of adult patients with ascites due to cirrhosis: an update.">{{cite web |url=http://guideline.gov/content.aspx?id=14887&search=ascitis |title=National Guideline Clearinghouse | Management of adult patients with ascites due to cirrhosis: an update. |format= |work= |accessdate=}}</ref> | ||
Revision as of 19:00, 13 June 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Patients with ascitic fluid protein concentration <1.0 g/dL, variceal hemorrhage, and prior episode of SBP should receive antibiotic prophylaxis.[1]
Primary prevention
- Prevention of ascites in cirrhosis, heart failure and renal failure.
- Prevention of peritonitis in cases of ascites.
- Intravenous ceftriaxone for 7 days or twice-daily norfloxacin for 7 days should be given to prevent bacterial infections in patients with cirrhosis and gastrointestinal hemorrhage. [2]
- Patients with cirrhosis and ascites but no gastrointestinal hemorrhage, long-term use of norfloxacin can be considered if the ascitic fluid protein <1.5 g/dL and one or more of the following are present: serum creatinine >1.2 mg/dL, blood urea nitrogen >25 mg/dL, serum sodium <130 mEq/L or Child-Pugh >9 points with bilirubin >3 mg/dL.[3][4]
- Intermittent dosing of antibiotics to prevent bacterial infections may be inferior to daily dosing (due to the development of bacterial resistance) and thus daily dosing should preferentially be used. [5]
References
- ↑ Runyon BA, AASLD Practice Guidelines Committee (2009). "Management of adult patients with ascites due to cirrhosis: an update". Hepatology. 49 (6): 2087–107. doi:10.1002/hep.22853. PMID 19475696.
- ↑ Soares-Weiser K, Brezis M, Tur-Kaspa R, Leibovici L (2002). "Antibiotic prophylaxis for cirrhotic patients with gastrointestinal bleeding". Cochrane database of systematic reviews (Online) (2): CD002907. PMID 12076458.
- ↑ Fernández J, Navasa M, Planas R, Montoliu S, Monfort D, Soriano G; et al. (2007). "Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis". Gastroenterology. 133 (3): 818–24. doi:10.1053/j.gastro.2007.06.065. PMID 17854593.
- ↑ Novella M, Solà R, Soriano G, Andreu M, Gana J, Ortiz J; et al. (1997). "Continuous versus inpatient prophylaxis of the first episode of spontaneous bacterial peritonitis with norfloxacin". Hepatology. 25 (3): 532–6. doi:10.1002/hep.510250306. PMID 9049193.
- ↑ "National Guideline Clearinghouse | Management of adult patients with ascites due to cirrhosis: an update".