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.
No comments:
Post a Comment