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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

C Guarner1, G Soriano

  • 1Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Seminars in Liver Disease
|January 1, 1997
PubMed

Insights

Spontaneous bacterial peritonitis (SBP) is an infection of ascitic fluid. Early diagnosis via paracentesis and antibiotic treatment, like cephalosporins, lead to high cure rates, while prophylaxis can prevent recurrence.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with ascites.
  • Pathogenesis involves bacterial translocation, impaired immune function, and reduced ascitic fluid antimicrobial capacity.
  • Varied clinical presentations and outcomes have been noted.

Purpose of the Study:

  • To review the pathogenesis, diagnosis, treatment, and prevention of spontaneous bacterial peritonitis.
  • To highlight the importance of early diagnosis and appropriate management strategies.

Main Methods:

  • Review of existing literature on spontaneous bacterial peritonitis.
  • Analysis of diagnostic criteria, including ascitic fluid analysis (WBC count, culture).
  • Evaluation of treatment options (e.g., cephalosporins, ofloxacin) and prophylactic measures (e.g., norfloxacin).

Main Results:

  • Early diagnosis through a low threshold for paracentesis is crucial.
  • Third-generation cephalosporins achieve >80% cure rates; oral ofloxacin is an option for select patients.
  • Prophylactic selective intestinal decontamination and long-term prophylaxis reduce SBP incidence but require monitoring for resistance.

Conclusions:

  • Prompt diagnosis and treatment of SBP are essential for favorable outcomes.
  • Prophylaxis is effective in high-risk patients but necessitates vigilance for resistant organisms.
  • Liver transplantation should be considered for SBP survivors due to poor long-term prognosis.

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