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Spontaneous bacterial peritonitis.

G Garcia-Tsao1

  • 1Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.

Gastroenterology Clinics of North America
|March 1, 1992
PubMed
Summary
This summary is machine-generated.

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Spontaneous bacterial peritonitis (SBP) is a serious infection in cirrhotic ascites patients. Early diagnosis and antibiotic treatment are crucial, though mortality remains high and recurrence is frequent.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a common infection in patients with cirrhotic ascites.
  • It affects 15-19% of patients, often caused by Gram-negative enteric bacteria.
  • Defects in immune function and low ascitic fluid protein increase susceptibility.

Purpose of the Study:

  • To summarize the current understanding of spontaneous bacterial peritonitis (SBP) in cirrhotic ascites.
  • To highlight diagnostic criteria and treatment strategies for SBP.
  • To discuss the prognosis and recurrence rates of SBP.

Main Methods:

  • Review of existing literature on spontaneous bacterial peritonitis (SBP).
  • Analysis of diagnostic indicators, including polymorphonuclear cell (PMN) count.

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  • Evaluation of treatment outcomes and prophylactic measures.

    • Main Results:

    • A PMN count >500/mm3 in ascitic fluid is indicative of SBP.
    • Prompt intravenous broad-spectrum antibiotic therapy reduces acute episode mortality.
    • Despite treatment, SBP mortality remains high (~50%), with frequent recurrences.

    Conclusions:

    • Early diagnosis and treatment of SBP are vital for improving outcomes in cirrhotic patients.
    • The severity of underlying liver disease significantly impacts SBP mortality.
    • Prophylactic antibiotics may reduce SBP incidence but not necessarily long-term survival.