Prophylaxis of SBP

A default section

1° or 2° prevention of spontaneous bacterial peritonitis in high risk patients, usually with liver cirrhosis through long-term antibiotic use

Diagnostic Pearls

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Prophylaxis decreases initial or recurrent episodes of SBP and may improve hemodynamics (e.g. ↑ BP and delay development of hepatorenal syndrome), and improves survival in advanced cirrhosis

Prophylaxis does not reduce hospitalizations or survival in mild-moderate cirrhosis

Long-term prophylaxis is also associated with carriage of multi-drug resistant organisms

Eligibility Criteria

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Previous history of SBP

Cirrhosis AND GI bleeding

Ascitic fluid protein concentration < 15 g/L

SCr > 100 mmol/L

BUN > 9 mmol/L

Sodium < 130 mmol/L

Child-Pugh score ≥ 9

Bilirubin > 30 mg/L