title: [Spontaneous bacterial peritonitis in patients with cirrhosis].
abstract: Spontaneous bacterial peritonitis (SBP) is a severe complication occurring in patients with cirrhosis, and is associated with high mortality. Liver transplantation should be considered after a first episode of SBP. Gram-negative bacilli are the major cause of SBP, however there is an increasing trend of Gram-positive cocci related SBP. Management includes empirical antibiotic treatment and albumin infusion. The choice of antibiotics depends on the site of acquisition (community-acquired vs nosocomial or health-care associated infection) and local resistance profile, due to the emergence of drug-resistant bacteria. Secondary prophylaxis is recommended after resolution of SBP and reduces recurrence and mortality. Primary prophylaxis in patients with low protein ascites (<15 g/L) should be restricted to patients with severe cirrhosis awaiting for liver transplantation.
authors.affiliation: CHU La Cavale-Blanche, service d'hépato-gastroentérologie, boulevard Tanguy-Prigent, 29609 Brest cedex, France. Electronic address: jean-baptiste.nousbaum@chu-brest.fr.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Nousbaum
mesh_terms: D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D024881:Drug Resistance, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006095:Gram-Positive Cocci / Q000187:drug effects; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D016031:Liver Transplantation; D010538:Peritonitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D011379:Prognosis; D012709:Serum Albumin / Q000008:administration & dosage
chemical_list: D012709:Serum Albumin