Oral ciprofloxacin versus intravenous cefotaxime and ceftriaxone in the treatment of spontaneous bacterial peritonitis.
OBJECTIVE
Cefotaxime or ceftriaxone were considered the first-choice antibiotic for empirical treatment in cirrhotic patients developing spontaneous bacterial peritonitis. It has been suggested that ciprofloxacin could be an alternative to cefotaxime or ceftriaxone in cirrhotic patients developing spontaneous bacterial peritonitis. The aim of the present study was to compare oral ciprofloxacin with cefotaxime and ceftriaxone in the treatment of spontaneous bacterial peritonitis in cirrhotic patients.


METHODS
Fifty-three hospitalized cirrhotic patients with spontaneous bacterial peritonitis were prospectively included and randomized into three groups: group A (n = 16); received orally 500 mg ciprofloxacin every 12 h, group B (n = 18); received intravenous cefotaxime 2 g every 8 h and group C (n = 19) received intravenous ceftriaxone 2 g every 24 h.


RESULTS
15 patients from the ciprofloxacin group, 17 from the cefotaxime group and 17 patients from the ceftriaxone group were finally analyzed. Spontaneous bacterial peritonitis resolution in three groups was found to be 80%, 76%, and 83%, respectively (p = NS). Incidence of complications and hospital mortality was similar in the three groups. No adverse events were observed in any of the three groups. The cost of the treatment was statistically lower in the ciprofloxacin group than in the cefotaxime group and ceftriaxone group (p < 0.001).


CONCLUSIONS
These results suggest that orally ciprofloxacin is as effective as cefotaxime and ceftriaxone in the empirical treatment of spontaneous bacterial peritonitis in cirrhotic patients, and is also less expensive and can be administered orally.
Yuzuncu Yil University Medical Faculty, Department of Gastroenterology, 65300 Van, Turkey. iltuncer@yahoo.com
Ilyas
I
Tuncer
Nazan
N
Topcu
Ahmet
A
Durmus
M Kursad
MK
Turkdogan
D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001202:Ascitic Fluid; D002439:Cefotaxime / Q000008:administration & dosage / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies
D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D002443:Ceftriaxone; D002439:Cefotaxime