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Updated: Aug 17, 2026

Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
06:45

Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis

Published on: December 18, 2010

Spontaneous bacterial peritonitis

Todd A Sheer1, Bruce A Runyon

  • 1Department of Internal Medicine, Division of Gastroenterology, Naval Medical Center San Diego, San Diego, Calif. 92134, USA. tasheer@nmcsd.med.navy.mil

Digestive Diseases (Basel, Switzerland)
|May 28, 2005
PubMed

Insights

Spontaneous bacterial peritonitis (SBP) is a serious infection in cirrhosis patients. Early diagnosis via paracentesis and prompt antibiotic treatment, like cefotaxime, significantly reduces mortality.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a common complication in patients with decompensated cirrhosis and ascites.
  • It involves bacterial translocation from the gut into the ascitic fluid.
  • SBP presents with diverse symptoms, necessitating a high index of suspicion.

Purpose of the Study:

  • To outline the diagnostic criteria and management strategies for spontaneous bacterial peritonitis.
  • To emphasize the importance of early detection and appropriate antibiotic therapy.

Main Methods:

  • Diagnostic paracentesis to analyze ascitic fluid for polymorphonuclear cell count and cultures.
  • Biochemical analysis of ascitic fluid (protein, LDH, glucose) to differentiate SBP from secondary peritonitis.
  • Empirical antibiotic therapy initiated promptly upon suspicion of SBP.

Main Results:

  • Ascitic fluid polymorphonuclear cell count is the most sensitive diagnostic marker.
  • Cefotaxime demonstrates excellent efficacy and safety for empirical treatment of SBP.
  • Early detection and treatment have led to a significant decline in SBP-related mortality.

Conclusions:

  • Prompt diagnosis using paracentesis and initiation of empirical antibiotic therapy are crucial for managing SBP.
  • Cefotaxime is a highly effective and safe treatment option.
  • Improved therapeutic approaches have dramatically reduced mortality rates associated with SBP.

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