Spontaneous bacterial peritonitis secondary prevention: Difference between revisions

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{{Spontaneous bacterial peritonitis}}
{{Spontaneous bacterial peritonitis}}
{{CMG}}; {{AE}} {{ADI}}
{{CMG}}; {{AE}} {{ADI}} {{SCh}}


==Overview==
==Overview==
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==Secondary Prevention==
==Secondary Prevention==


* All patients who have survived an episode of SBP should receive long-term prophylaxis with daily [[norfloxacin]] (or [[trimethoprim/sulfamethoxazole]]) because this is the most data-supported indication for long-term outpatient prophylaxis. <ref>http://guideline.gov/content.aspx?id=14887&search=ascitis</ref>
* All patients who have survived an episode of SBP should receive long-term prophylaxis with daily [[norfloxacin]] (or [[trimethoprim/sulfamethoxazole]]) because this is the most data-supported indication for long-term outpatient prophylaxis to prevent future episodes ( 40-70% risk of recurrence in 1 year ). <ref>http://guideline.gov/content.aspx?id=14887&search=ascitis</ref>


* All cirrhotic patients might benefit from antibiotics if:
* All cirrhotic patients might benefit from antibiotics if:

Revision as of 02:52, 17 January 2017

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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] Shivani Chaparala M.B.B.S [3]

Overview

Secondary Prevention

  • All patients who have survived an episode of SBP should receive long-term prophylaxis with daily norfloxacin (or trimethoprim/sulfamethoxazole) because this is the most data-supported indication for long-term outpatient prophylaxis to prevent future episodes ( 40-70% risk of recurrence in 1 year ). [1]
  • All cirrhotic patients might benefit from antibiotics if:
    • Ascitic fluid protein <1.0 g/dL[2]. Patients with fluid protein <15 g/L and either Child-Pugh score of at least 9 or impaired renal function may also benefit.
    • Previous SBP[3]

References

  1. http://guideline.gov/content.aspx?id=14887&search=ascitis
  2. Runyon BA (1986). "Low-protein-concentration ascitic fluid is predisposed to spontaneous bacterial peritonitis". Gastroenterology. 91 (6): 1343–6. PMID 3770358.
  3. 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.


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