scholarly journals PTH-096 Antibiotic use in primary and secondary prophylaxis of spontaneous bacterial peritonitis for liver cirrhosis patients

2018 ◽  
Author(s):  
Arif Hussenbux ◽  
Lysander Gourbault ◽  
Victoria Blackwell ◽  
John Ryan ◽  
Jane Collier
Keyword(s):  
Liver Cirrhosis ◽  
Spontaneous Bacterial Peritonitis ◽  
Antibiotic Use ◽  
Secondary Prophylaxis ◽  
Bacterial Peritonitis

scholarly journals Spontán bakteriális peritonitis

2017 ◽  
Vol 158 (2) ◽  
pp. 50-57
Author(s):  
Bálint Velkey ◽  
Eszter Vitális ◽  
Zsuzsanna Vitális
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Antibiotic Sensitivity ◽  
Antibiotic Use ◽  
Primary Prophylaxis ◽  
Generation Cephalosporin ◽  
Secondary Prophylaxis ◽  
Bacterial Peritonitis ◽  
Gram Positive Bacteria ◽  
Amoxicillin Clavulanic Acid ◽  
Cirrhotic Patients

Abstract: Spontaneous bacterial peritonitis occurs most commonly in cirrhotic patients with ascites. Pathogens get into the circulation by intestinal translocation and colonize in peritoneal fluid. Diagnosis of spontaneous bacterial peritonitis is based on elevated polymorphonuclear leukocyte count in the ascites (>0,25 G/L). Ascites culture is often negative but aids to get information about antibiotic sensitivity in positive cases. Treatment in stable patient can be intravenous then orally administrated ciprofloxacin or amoxicillin/clavulanic acid, while in severe cases intravenous III. generation cephalosporin. Nosocomial spontaneous bacterial peritonitis often caused by Gram-positive bacteria and multi-resistant pathogens can also be expected thus carbapenem should be the choice of the empiric treatment. Antibiotic prophylaxis should be considered. Norfloxacin is used most commonly, but changes are expected due to increase in quinolone resistance. As a primary prophylaxis, a short-term antibiotic treatment is recommended after gastrointestinal bleeding for 5 days, while long-term prophylaxis is for patients with low ascites protein, and advanced disease (400 mg/day). Secondary prophylaxis is recommended for all patients recovered from spontaneous bacterial peritonitis. Due to increasing antibiotic use of antibiotics prophylaxis is debated to some degree. Orv. Hetil., 2017, 158(2), 50–57.

scholarly journals The Risk of Clostridioides difficile Infection in Cirrhotic Patients Receiving Norfloxacin for Secondary Prophylaxis of Spontaneous Bacterial Peritonitis—A Real Life Cohort

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 964
Author(s):  
Irina Girleanu ◽  
Anca Trifan ◽  
Laura Huiban ◽  
Cristina Muzica ◽  
Roxana Nemteanu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Spontaneous Bacterial Peritonitis ◽  
Real Life ◽  
Secondary Prophylaxis ◽  
Cox Regression Analysis ◽  
Bacterial Peritonitis ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Cirrhotic Patients

Background and Objectives: Spontaneous bacterial peritonitis (SBP) is a life-threatening complication of liver cirrhosis. Antibiotic prophylaxis is effective but can lead to an increased incidence of Clostridioides difficile infection (CDI). The aim of this study was to evaluate the incidence of CDI and the risk factors in cirrhotic patients with a previous episode of SBP receiving norfloxacin as secondary prophylaxis. Materials and Methods: We performed a prospective, cohort study including patients with liver cirrhosis and SBP, successfully treated over a 2-year period in a tertiary university hospital. All the patients received secondary prophylaxis for SBP with norfloxacin 400 mg/day. Results: There were 122 patients with liver cirrhosis and SBP included (mean age 57.5 ± 10.8 years, 65.5% males). Alcoholic cirrhosis was the major etiology accounting for 63.1% of cases. The mean MELD score was 19.7 ± 6.1. Twenty-three (18.8%) of all patients developed CDI during follow-up, corresponding to an incidence of 24.8 cases per 10,000 person-years. The multivariate Cox regression analysis demonstrated that alcoholic LC etiology (HR 1.40, 95% CI 1.104–2.441, p = 0.029) and Child-Pugh C class (HR 2.50, 95% CI 1.257–3.850, p = 0.034) were independent risk factors for CDI development during norfloxacin secondary prophylaxis. The development of CDI did not influence the mortality rates in cirrhotic patients with SBP receiving norfloxacin. Conclusions: Cirrhotic patients with SBP and Child-Pugh C class and alcoholic liver cirrhosis had a higher risk of developing Clostridioides difficile infection during norfloxacin secondary prophylaxis. In patients with alcoholic Child-Pugh C class liver cirrhosis, alternative prophylaxis should be evaluated as SBP secondary prophylaxis.

scholarly journals Antibiotic prophylaxis for prevention of spontaneous bacterial peritonitis in liver cirrhosis: systematic review

2021 ◽  
Vol 84 (2) ◽  
pp. 333-342
Author(s):  
R Pimentel ◽  
C Gregório ◽  
P Figueiredo
Keyword(s):  
Systematic Review ◽  
Liver Cirrhosis ◽  
Spontaneous Bacterial Peritonitis ◽  
Secondary Prophylaxis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Bacterial Peritonitis ◽  
Increased Risk ◽  
Cirrhotic Patients

Background and aim: Spontaneous bacterial peritonitis is a potentially life-threatening infection in patients with liver cirrhosis and ascites. Its prevention is vital to improve prognosis of cirrhotic patients. The main objective of this systematic review was to evaluate what is the most efficacious and safest antibiotic prophylactic strategy. Methods: Studies were located by searching PubMed and Cochrane Central Register of Controlled Trials in The Cochrane Library until February 2019. Randomized controlled trials evaluating primary or secondary spontaneous bacterial peritonitis prophylaxis in cirrhotic patients with ascites were included. The selection of studies was performed in two stages: screening of titles and abstracts, and assessment of the full papers identified as relevant, considering the inclusion criteria. Data were extracted in a standardized way and synthesized qualitatively. Results: Fourteen studies were included. This systematic review demonstrated that daily norfloxacin is effective as a prophylactic antibiotic for the prevention of spontaneous bacterial peritonitis in patients with cirrhosis. Once weekly ciprofloxacin was not inferior to once daily norfloxacin, with good tolerance and no induced resistance. Trimethoprim-sulfamethoxazole and norfloxacin have similar efficacy for primary and secondary prophylaxis of spontaneous bacterial peritonitis, however, trimethoprim-sulfamethoxazole was associated with an increased risk of developing an adverse event. Rifaximin was more effective than norfloxacin in the secondary prophylaxis of spontaneous bacterial peritonitis, with a significant decrease in adverse events and mortality rate. Conclusions: Continuous long-term selective intestinal decontamination with norfloxacin is the most widely used prophylactic strategy in spontaneous bacterial peritonitis, yet other equally effective and safe options are available.

scholarly journals Spontaneous Bacterial Peritonitis Caused byHafnia alveiin a Patient with Liver Cirrhosis

2010 ◽  
Vol 42 (6) ◽  
pp. 420 ◽  
Author(s):  
Sang Kyung Jung ◽  
June Sung Lee ◽  
Kyung Ah Kim ◽  
Young Doo Kim ◽  
Yoon Jung Jwa ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis

scholarly journals Renal impairment after Spontaneous Bacterial Peritonitis (SBP) in cirrhotic population.

2019 ◽  
Vol 26 (12) ◽  
pp. 2235-2240
Author(s):  
Asif Javaid Wakani ◽  
Riaz Hussain Awan ◽  
Seema Nayab ◽  
Khadim Hussain Awan ◽  
Faqir Muhammad Awan
Keyword(s):  
Liver Cirrhosis ◽  
Renal Impairment ◽  
Serum Creatinine ◽  
Spontaneous Bacterial Peritonitis ◽  
National Hospital ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Serum Blood Urea Nitrogen ◽  
Patient’S Information ◽  
The Mean

Objectives: To evaluate the frequency of renal impairment after spontaneous bacterial peritonitis (SBP) in cirrhotic population. Study Design: The study was conducted as Descriptive Cross-Sectional. Setting: Liaquat National Hospital Karachi. Period: For six months (October 01, 2015 to March 31, 2016). Methodology: The subjects with liver cirrhosis spontaneous bacterial peritonitis (SBP) were evaluated for serum creatinine and serum blood urea nitrogen (BUN) for evaluation of renal impairment while the patient’s information was recorded on proforma and analyzed in SPSS-15.0. Results: The mean ±SD of age, BUN and serum creatinine for whole population was 50.69±10.69 years, 22.4197±11.64742 and 1.2207±0.92535. Renal impairment was detected in 40 (27.2%) individuals while it is normal in 107 (72.8%) subjects. Conclusion: The renal impairment after SBP in cirrhotic population is higher in present study.

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