Ceftriaxone in the treatment of spontaneous bacterial peritonitis: ascitic fluid polymorphonuclear count response and short-term prognosis.
OBJECTIVE
In this study, ascitic fluid polymorphonuclear (PMN) response, short-term prognosis, and factors related to hospital mortality were investigated in 62 cases of spontaneous bacterial peritonitis occurring in cirrhotic patients treated with Ceftriaxone (1g every 12 hours).


METHODS
The diagnostic criteria for (SBP) were ascitic fluid PMN count < 250 cells/mm3 and no evidence of secondary peritonitis. Analysis of ascitic fluid samples were obtained on admission, and on the 4th and 10th days of antibiotic therapy.


RESULTS
The etiology of cirrhosis was alcohol in 63% of the cases, and 79.5% of patients belonged to Child-Pugh Class C. Ascitic fluid analysis showed positive cultures in 47% of the cases, and a marked decrease in PMN count during treatment (admission: 7762 +/- 2837; 4th day: 388 +/- 91; 10th day: 173 +/- 59 cells/mm3). Ascitic PMN was < 250 cells/mm3 within 4 days of treatment in 33% of the cases. The hospital mortality rate was 24%, and was related to gastrointestinal hemorrhage, hepatic encephalopathy, renal failure and 4th day ascitic fluid PMN count.


CONCLUSIONS
Ceftriaxone is a safe and effective option for the treatment of SBP.
Mesquita
M A
MA
Department of Medicine, University of Campinas, Brazil.
Balbino
E P
EP
Albuquerque
R S
RS
Carmona
C A
CA
Okubo
B T
BT
Lorena
S L
SL
Montes
C G
CG
Soares
E C
EC
D001202:Ascitic Fluid / Q000166:cytology; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D002443:Ceftriaxone / Q000627:therapeutic use*; D002452:Cell Count; D002511:Cephalosporins / Q000627:therapeutic use*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects*; D010538:Peritonitis / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D013997:Time Factors
D002511:Cephalosporins; D002443:Ceftriaxone