Related Experiment Video
Updated: Jun 22, 2026

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
beta-Blockers protect against spontaneous bacterial peritonitis in cirrhotic patients: a meta-analysis
Marco Senzolo1, Evangelos Cholongitas, Patrizia Burra
1The Royal Free Sheila Sherlock Liver Centre, Department of Surgery, London, UK.
Introduction:
Bacterial infections have been hypothetized to be a trigger of variceal bleeding in cirrhotic patients and beta-blockers may have a protective effect by decreasing bacterial translocation, reducing portal pressure. The aim of our study was to evaluate the possible role of beta-blockers in preventing spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis and ascites.
Materials And Methods:
Extensive search of the literature including randomized controlled trial (RCT) and non-RCT of primary and secondary prophylaxis for variceal bleeding in cirrhotics using beta-blockers were evaluated. We performed a meta-analysis using the occurrence of SBP as endpoint in all the studies, using the random effect model.
Results:
Three RCT and three retrospective studies in which beta-blockers were evaluated against no treatment for the prevention of SBP in ascitic cirrhotics were included. There was a statistically significant difference of 12.1%, P<0.001 in favour of propranolol in preventing SBP, which was confirmed by sensitivity analysis evaluating only RCTs (7.8% difference). The effect was still present when haemodynamic responders were compared with non-responders.
Conclusions:
This analysis suggests a role of beta-blockers in preventing SBP in ascitic cirrhotics, independent of haemodynamic response. Further formal RCTs are needed to confirm this finding.
Related Concept Videos
Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
Antihypertensive Drugs: Types of β-Blockers
Heart Failure Drugs: β-Blockers
Antihypertensive Drugs: Action of β1 Blockers
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
Adrenergic Antagonists: ɑ and β-Receptor Blockers
