Spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis - Acute
Rahul Soman, M. Pharm

 

 

Definition  

A potentially devastating complication in patients with ascites, especially those with underlying cirrhosis. Spontaneous bacterial peritonitis (SBP) is more specifically defined as an ascites fluid polymorphonuclear leukocyte (PMN) count of 250 or greater (regardless of culture results, which may be negative).

 

Medical History  

* Ascites [Ascites - Acute]

* Cirrhosis of liver [Cirrhosis of liver - Acute]

* Gastrointestinal hemorrhage

* Immune defect

* Past medical history of Spontaneous bacterial peritonitis

* Gastrointestinal tract endoscopy

* Past medical history of Creation of peritoneal-venous shunt

 

Findings  

* Unspecified encephalopathy

* Abdominal pain, acute

* Abdominal tenderness

* Fever

* Peripheral edema

* Swollen abdomen

 

Tests  

 

Spontaneous bacterial peritonitis  

* Body fluid analysis, Peritoneal fluid

 

Treatment  

 

Drug Therapy  

 

Suspected or known spontaneous bacterial peritonitis  

 

CEFOTAXIME SODIUM  

Adults: 1-2 g IV every 4 to 8 hours, adjusted for renal function

 

Spontaneous bacterial peritonitis  

 

OFLOXACIN  

 

ALBUMIN HUMAN  

Adults: 1.5 g/kg within 6 hours of detection and 1 g/kg on day 3

 

Short-term prophylaxis against spontaneous bacterial peritonitis in patients with cirrhosis, with or without ascites, and gastrointestinal hemorrhage  

 

NORFLOXACIN  

Adults: 400 mg orally twice a day for 7 days

 

CIPROFLOXACIN  

 

CEFTRIAXONE SODIUM  

Adults: 1 g IV per day

 

Procedural Therapy  

 

Decompensated liver disease  

* Transplantation of liver: Given the poor long-term prognosis for patients with ascites and the long waiting time for liver transplantation, this option should be considered early.