Spontaneous bacterial peritonitis (SBP) in cirrhotic ascites: a prospective study in a tertiary care hospital, Nepal.
BACKGROUND
Spontaneous bacterial peritonitis (SBP) is one of the potentially lethal complications of cirrhosis and is defined as infected ascites in the absence of any recognizable secondary cause of infection. Objective was to study the occurrence of SBP, clinical and laboratory characteristics and the response to antibiotics.


METHODS
We had prospectively evaluated 81 cirrhotic patients with ascites during one-year period. All SBP patients were treated with cefotaxime, 2gm IV, every 12h for 5days.


RESULTS
Of these 81 patients, 24.67% of patients (n=20) had SBP and its variants (classical SBP n= 4, CNNA n=13 and bacterascites n=3). There were thirteen males and 7 females in the study.85% of the cases had Child;s class C cirrhosis. UGI bleeding and abdominal pain were the most common presenting symptoms of SBP. Culture positives were 35% (n=7). The most frequent organisms were Escherichia coli (n=3) and Streptococcus pneumoniae (n=2). 94% of the patients responded to therapy after 48 hours of treatment. Total resolution after 5 days of therapy was 73% and in-hospital mortality was 15% (n=3).


CONCLUSIONS
SBP, if diagnosed early can be treated with very good success rate up to 73%. Appropriate treatment of SBP with cefotaxime can help in reducing mortality and morbidity in patients with chronic liver disease.
Syed
V A
VA
Department Of Internal Medicine BP Koirala Institute Of Health Sciences, Dharan, Nepal. vaqarahmad@yahoo.com
Ansari
J A
JA
Karki
P
P
Regmi
M
M
Khanal
B
B
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001201:Ascites / Q000150:complications*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002439:Cefotaxime / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D010538:Peritonitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011446:Prospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002439:Cefotaxime