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CC BY-NC-ND 4.0 · Journal of Gastrointestinal Infections 2022; 12(01): 051-056
DOI: 10.1055/s-0042-1757543
Evidence-Based Commentary

Evidence-Based Commentary: Antibiotics for Prophylaxis of Spontaneous Bacterial Peritonitis

Ifrah Fatima 
1   Department of Internal Medicine, University of Missouri–Kansas City, Kansas City, Missouri, United States
,
Anand V. Kulkarni 
2   Department of Hepatology, Asian Institute of Gastroenterology (AIG) Hospitals, Hyderabad, Telangana, India
› Institutsangaben
Funding None.
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Introduction

Ascites is the major decompensating event in the natural history of cirrhosis.[1] Peritoneal infection is one of the most common sites of infection in cirrhosis.[2] Ascitic fluid infection without any evidence of a surgically treatable intra-abdominal source is termed as spontaneous bacterial peritonitis (SBP).[2] The diagnosis of SBP is established by demonstrating ≥ 250/mm3 polymorphonuclear cells on ascitic fluid analysis (performed with strict aseptic precautions) irrespective of the culture positivity in a cirrhosis patient presenting with or without symptoms of peritoneal infection, that is, fever, abdominal pain, tenderness, diarrhea, or ileus.[3] The prevalence of SBP is approximately 1.2 to 3.5% in outpatients and 10 to 27% in hospitalized patients with cirrhosis.[4] SBP is an indication for liver transplantation as the recurrence rate is as high as 70% at 1 year and is associated with high mortality.[5] Therefore, selective intestinal decontamination (SID) with antibiotics may reduce the incidence of SBP and positively impact the course of cirrhosis patients. In this commentary, we will discuss the indications, advantages, and disadvantages of prophylactic antibiotics to prevent SBP.

Ethical Statement

None.


Author Contributions

I.F.: Initial draft and tables. AVK: Critical revision and figures. Both authors approved final version.


Data Availability Statement

The data associated can be obtained from the corresponding author on reasonable request.


Supplementary Material



Publikationsverlauf

Eingereicht: 21. April 2022

Angenommen: 07. Juni 2022

Artikel online veröffentlicht:
22. September 2023

© 2022. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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