title: Spontaneous Bacterial Peritonitis.
abstract: A suspicion, even if low, of spontaneous bacterial peritonitis (SBP) should prompt a diagnostic paracentesis to be performed on presentation. Empiric antibiotic therapy with a third-generation cephalosporin should commence upon demonstration of over 250 granulocytes/mm(3) in ascitic fluid. Treatment for 5 days in uncomplicated SBP is sufficient; persistent symptoms and/or ascites fluid showing persistent granulocytosis (over 250 cells/mm(3)) should be handled by broadening of antibiotic spectrum and searching for secondary causes of peritonitis. Antibiotic prophylaxis for cirrhotic patients with ascites and acute gastrointestinal hemorrhage and in those with a prior history of SBP is indicated.
authors.affiliation: Yale University School of Medicine, Digestive Diseases 1080 LMP, 333 Cedar St., New Haven, CT 06520-8019, USA.
authors.initials: VJ
authors.lastname: Navarro