Spontaneous bacterial peritonitis secondary prevention: Difference between revisions

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** Previous SBP<ref name="pmid9764990">{{cite journal |author=Grangé JD, Roulot D, Pelletier G, ''et al'' |title=Norfloxacin primary prophylaxis of bacterial infections in cirrhotic patients with ascites: a double-blind randomized trial |journal=J. Hepatol. |volume=29 |issue=3 |pages=430-6 |year=1998 |pmid=9764990 |doi=}}</ref>
** Previous SBP<ref name="pmid9764990">{{cite journal |author=Grangé JD, Roulot D, Pelletier G, ''et al'' |title=Norfloxacin primary prophylaxis of bacterial infections in cirrhotic patients with ascites: a double-blind randomized trial |journal=J. Hepatol. |volume=29 |issue=3 |pages=430-6 |year=1998 |pmid=9764990 |doi=}}</ref>


* Rifaximin was more effective than norfloxacin in the secondary prevention of SBP as encephalopathy-related mortality and side effects were fewer with rifaximin than norfloxacin.<ref name="ElfertAbo Ali2016">{{cite journal|last1=Elfert|first1=Asem|last2=Abo Ali|first2=Lobna|last3=Soliman|first3=Samah|last4=Ibrahim|first4=Shimaa|last5=Abd-Elsalam|first5=Sherief|title=Randomized-controlled trial of rifaximin versus norfloxacin for secondary prophylaxis of spontaneous bacterial peritonitis|journal=European Journal of Gastroenterology & Hepatology|volume=28|issue=12|year=2016|pages=1450–1454|issn=0954-691X|doi=10.1097/MEG.0000000000000724}}</ref>
* Rifaximin was more effective than norfloxacin in the secondary prevention of SBP as encephalopathy-related mortality and side effects were fewer with rifaximin than norfloxacin.<ref name="ElfertAbo Ali2016">{{cite journal|last1=Elfert|first1=Asem|last2=Abo Ali|first2=Lobna|last3=Soliman|first3=Samah|last4=Ibrahim|first4=Shimaa|last5=Abd-Elsalam|first5=Sherief|title=Randomized-controlled trial of rifaximin versus norfloxacin for secondary prophylaxis of spontaneous bacterial peritonitis|journal=European Journal of Gastroenterology & Hepatology|volume=28|issue=12|year=2016|pages=1450–1454|issn=0954-691X|doi=10.1097/MEG.0000000000000724}}</ref><ref name="DongAronsohn2016">{{cite journal|last1=Dong|first1=Tien|last2=Aronsohn|first2=Andrew|last3=Gautham Reddy|first3=K.|last4=Te|first4=Helen S.|title=Rifaximin Decreases the Incidence and Severity of Acute Kidney Injury and Hepatorenal Syndrome in Cirrhosis|journal=Digestive Diseases and Sciences|volume=61|issue=12|year=2016|pages=3621–3626|issn=0163-2116|doi=10.1007/s10620-016-4313-0}}</ref>


==References==
==References==

Revision as of 18:55, 22 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][2]
  • All cirrhotic patients might benefit from antibiotics if:
    • Ascitic fluid protein <1.0 g/dL[3]. 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[4]
  • Rifaximin was more effective than norfloxacin in the secondary prevention of SBP as encephalopathy-related mortality and side effects were fewer with rifaximin than norfloxacin.[5][6]

References

  1. http://guideline.gov/content.aspx?id=14887&search=ascitis
  2. Ginés, Pere; Rimola, Antoni; Planas, Ramón; Vargas, Victor; Marco, Francesc; Almela, Manuel; Forne, Montserrat; Miranda, Maria Luisa; Llach, Josep; Salmerón, Joan Manuel; Esteve, Maria; Marques, Josep Maria; de Anta, Maria Teresa Jiménez; Arroyo, Vicente; Rodés, Joan (1990). "Norfloxacin prevents spontaneous bacterial peritonitis recurrence in cirrhosis: Results of a double-blind, placebo-controlled trial". Hepatology. 12 (4): 716–724. doi:10.1002/hep.1840120416. ISSN 0270-9139.
  3. Runyon BA (1986). "Low-protein-concentration ascitic fluid is predisposed to spontaneous bacterial peritonitis". Gastroenterology. 91 (6): 1343–6. PMID 3770358.
  4. 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.
  5. Elfert, Asem; Abo Ali, Lobna; Soliman, Samah; Ibrahim, Shimaa; Abd-Elsalam, Sherief (2016). "Randomized-controlled trial of rifaximin versus norfloxacin for secondary prophylaxis of spontaneous bacterial peritonitis". European Journal of Gastroenterology & Hepatology. 28 (12): 1450–1454. doi:10.1097/MEG.0000000000000724. ISSN 0954-691X.
  6. Dong, Tien; Aronsohn, Andrew; Gautham Reddy, K.; Te, Helen S. (2016). "Rifaximin Decreases the Incidence and Severity of Acute Kidney Injury and Hepatorenal Syndrome in Cirrhosis". Digestive Diseases and Sciences. 61 (12): 3621–3626. doi:10.1007/s10620-016-4313-0. ISSN 0163-2116.


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