Spontaneous bacterial peritonitis secondary prevention: Difference between revisions

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* All cirrhotic patients might benefit from antibiotics if:
* All cirrhotic patients might benefit from antibiotics if:
** Ascitic fluid protein <1.0 g/dL<ref name="pmid3770358">{{cite journal |author=Runyon BA |title=Low-protein-concentration ascitic fluid is predisposed to spontaneous bacterial peritonitis |journal=Gastroenterology |volume=91 |issue=6 |pages=1343-6 |year=1986 |pmid=3770358 |doi=}}</ref>. Patients with fluid protein <15 g/L and either Child-Pugh score of at least 9 or impaired renal function may also benefit.
** Ascitic fluid protein <1.0 g/dL<ref name="pmid3770358">{{cite journal |author=Runyon BA |title=Low-protein-concentration ascitic fluid is predisposed to spontaneous bacterial peritonitis |journal=Gastroenterology |volume=91 |issue=6 |pages=1343-6 |year=1986 |pmid=3770358 |doi=}}</ref>. 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<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>



Revision as of 21:28, 1 August 2012

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

Overview

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. [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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