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

Published on: December 18, 2010

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[Spontaneous bacterial peritonitis]

Bálint Velkey1, Eszter Vitális2, Zsuzsanna Vitális1

  • 1Belgyógyászati Intézet, Gasztroenterológia Nem Önálló Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen, Nagyerdei krt. 98., 4032.

Orvosi Hetilap
|January 17, 2017
PubMed

Insights

Spontaneous bacterial peritonitis (SBP) in cirrhotic patients is diagnosed by high white blood cell counts in ascites fluid. Treatment varies from oral antibiotics for stable patients to intravenous options for severe cases, with prophylaxis strategies evolving due to resistance.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a common complication in cirrhotic patients with ascites.
  • Intestinal translocation of pathogens leads to SBP, with diagnosis based on elevated ascitic fluid polymorphonuclear leukocyte count (>0.25 G/L).
  • Ascites cultures are frequently negative, limiting antibiotic sensitivity data.

Purpose of the Study:

  • To review diagnostic criteria for SBP.
  • To outline current and evolving treatment strategies for SBP.
  • To discuss antibiotic prophylaxis protocols for SBP in cirrhotic patients.

Main Methods:

  • Literature review of diagnostic and therapeutic approaches to SBP.
  • Analysis of antibiotic choices based on patient stability and pathogen resistance.
  • Evaluation of primary and secondary antibiotic prophylaxis guidelines.

Main Results:

  • Empiric treatment for SBP includes ciprofloxacin or amoxicillin/clavulanic acid for stable patients, and third-generation cephalosporins for severe cases.
  • Nosocomial SBP may require carbapenems due to multi-resistant pathogens.
  • Norfloxacin is common for prophylaxis, but quinolone resistance necessitates alternative strategies.

Conclusions:

  • Antibiotic prophylaxis for SBP is crucial but debated due to rising resistance.
  • Primary prophylaxis involves short-term treatment post-GI bleed or long-term for advanced disease.
  • Secondary prophylaxis is recommended for all SBP survivors, though evolving resistance patterns require ongoing reassessment.
Keywords:
antibiotic prophylaxisintestinalis bakteriális transzlokációkezelésmájzsugorprofilaxisspontaneous bacterial peritonitistreatment

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