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Spontaneous bacterial peritonitis: pathogenesis, diagnosis, and management
1Medico Adjunto Servicio de Patologia Digestiva, Autonomous University of Barcelona, Spain.
The Gastroenterologist
|December 1, 1995
Summary
Spontaneous bacterial peritonitis (SBP) is a serious cirrhosis complication. Early detection and treatment with antibiotics improve survival, but long-term prognosis remains poor due to liver disease severity and infection recurrence.
Area of Science:
- Hepatology
- Infectious Diseases
- Gastroenterology
Background:
- Spontaneous bacterial peritonitis (SBP) is a frequent and life-threatening complication in patients with cirrhosis.
- Pathogenesis involves gut bacterial translocation, impaired immune function, and reduced ascitic fluid defenses.
Purpose of the Study:
- To review the clinical presentation, diagnosis, treatment, and prognosis of spontaneous bacterial peritonitis in cirrhosis.
- To highlight the importance of early diagnosis and the role of selective intestinal decontamination and liver transplantation.
Main Methods:
- Review of current literature on spontaneous bacterial peritonitis in cirrhosis.
- Analysis of diagnostic criteria, including ascitic fluid polymorphonuclear cell count and culture.
- Evaluation of treatment outcomes with third-generation cephalosporins and preventive strategies.
Main Results:
- Third-generation cephalosporins achieve cure rates exceeding 80% for SBP.
- Despite treatment, long-term survival is limited by underlying liver disease and high recurrence rates.
- Selective intestinal decontamination is recommended for high-risk patients.
Conclusions:
- Early diagnosis and prompt antibiotic treatment are crucial for improving short-term survival in SBP.
- SBP signifies a poor prognosis in cirrhosis, underscoring the need for preventive measures and consideration of liver transplantation.