Spontaneous bacterial peritonitis secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

All cirrhotic patients might benefit from antibiotics if:

Ascitic fluid protein <1.0 g/dL^[1]. Patients with fluid protein <15 g/L and either Child-Pugh score of at least 9 or impaired renal function may also benefit.^[2]

Cirrhotic patients admitted to the hospital should receive antibiotics if:

↑ Runyon BA (1986). "Low-protein-concentration ascitic fluid is predisposed to spontaneous bacterial peritonitis". Gastroenterology. 91 (6): 1343–6. PMID 3770358.
↑ Fernández J, Navasa M, Planas R; 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.
↑ Grangé JD, Roulot D, Pelletier G; et al. (1998). "Norfloxacin primary prophylaxis of bacterial infections in cirrhotic patients with ascites: a double-blind randomized trial". J. Hepatol. 29 (3): 430–6. PMID 9764990.
↑ 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.