title: Short-course versus long-course antibiotic treatment of spontaneous bacterial peritonitis. A randomized controlled study of 100 patients.
abstract: In an attempt to determine the optimal duration of therapy of spontaneous bacterial peritonitis, 100 patients with neutrocytic ascites and suspected spontaneous bacterial peritonitis were randomized to short-course vs. long-course treatment groups. Empiric therapy was initiated before the results of ascitic fluid culture were available. Of the 90 patients who met strict criteria for spontaneous bacterial peritonitis or culture-negative neutrocytic ascites, 43 were randomized to a group receiving 5 days and 47 to a group receiving 10 days of single-agent cefotaxime, 2 g IV every 8 hours. Infection-related mortality (0% vs. 4.3%), hospitalization mortality (32.6% vs. 42.5%), bacteriologic cure (93.1% vs. 91.2%), and recurrence of ascitic fluid infection (11.6% vs. 12.8%) were not significantly different between the 5- and 10-day treatment groups, respectively. Recurrence rates were comparable to the values reported in the literature. The cost of antibiotic and antibiotic administration were significantly lower in the short-course group. Short-course treatment of spontaneous bacterial peritonitis is as efficacious as long-course therapy and significantly less expensive.
authors.affiliation: Liver Unit, University of Southern California School of Medicine, Los Angeles.
authors.forename: B A
authors.initials: BA
authors.lastname: Runyon
authors.forename: J G
authors.initials: JG
authors.lastname: McHutchison
authors.forename: M R
authors.initials: MR
authors.lastname: Antillon
authors.forename: E A
authors.initials: EA
authors.lastname: Akriviadis
authors.forename: A A
authors.initials: AA
authors.lastname: Montano
mesh_terms: D001424:Bacterial Infections / Q000188:drug therapy* / Q000401:mortality; D002439:Cefotaxime / Q000008:administration & dosage / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D013997:Time Factors
chemical_list: D002439:Cefotaxime