Selective intestinal decontamination prevents spontaneous bacterial peritonitis

Area of Science:

• Gastroenterology and Hepatology
• Infectious Diseases
• Clinical Pharmacology

Background:

• Cirrhosis patients with low ascitic fluid protein are at high risk for infections.
• Spontaneous bacterial peritonitis (SBP) is a common and serious complication.

Purpose of the Study:

• To evaluate the efficacy of selective intestinal decontamination (SID) with norfloxacin in preventing infections in hospitalized cirrhotic patients.

Main Methods:

• Prospective randomized study comparing 32 cirrhotic patients receiving norfloxacin with 31 controls.
• Focus on patients with low ascitic fluid total protein levels.

Main Results:

• Significantly lower incidence of infections (3.1% vs 41.9%) and SBP (0% vs 22.5%) in the norfloxacin group.
• Reduced, though not statistically significant, extraperitoneal infections (3.1% vs 22.5%).
• Significant reduction in infections and SBP among patients admitted for ascites.

Conclusions:

• Selective intestinal decontamination with norfloxacin is effective in preventing SBP and extraperitoneal infections.
• This prophylactic strategy is beneficial for hospitalized cirrhotic patients with low ascitic fluid protein.