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Ceftriaxone in the treatment of spontaneous bacterial peritonitis: ascitic fluid polymorphonuclear count response and

M A Mesquita1, E P Balbino, R S Albuquerque

  • 1Department of Medicine, University of Campinas, Brazil.

Hepato-Gastroenterology
|November 14, 1997
PubMed
Abstract

Insights

Ceftriaxone effectively treats spontaneous bacterial peritonitis (SBP) in cirrhotic patients, reducing ascitic fluid polymorphonuclear cells and improving prognosis. Hospital mortality was linked to specific complications and PMN levels during treatment.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Spontaneous bacterial peritonitis (SBP) is a serious complication in cirrhotic patients.
  • Alcohol-induced cirrhosis and advanced Child-Pugh Class C were common in the study population.
  • Understanding SBP treatment response and mortality factors is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of Ceftriaxone in treating SBP in cirrhotic patients.
  • To assess the ascitic fluid polymorphonuclear (PMN) response to Ceftriaxone therapy.
  • To identify factors associated with hospital mortality in SBP patients.

Main Methods:

  • A study of 62 cirrhotic patients diagnosed with SBP.
  • Treatment with Ceftriaxone (1g every 12 hours).
  • Ascitic fluid analysis, including PMN counts, on admission, day 4, and day 10.

Main Results:

  • Ceftriaxone treatment led to a significant decrease in ascitic fluid PMN counts.
  • 33% of patients achieved PMN counts below 250 cells/mm3 within 4 days.
  • Hospital mortality rate was 24%, associated with gastrointestinal hemorrhage, hepatic encephalopathy, renal failure, and day 4 PMN count.

Conclusions:

  • Ceftriaxone is a safe and effective antibiotic for treating SBP in cirrhotic patients.
  • Early reduction in ascitic fluid PMN count may correlate with improved outcomes.
  • Factors like hemorrhage, encephalopathy, and renal failure significantly impact mortality.

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