Spontaneous bacterial peritonitis: Difference between revisions
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==Treatment== | ==Treatment== | ||
The role of antibiotics is not clear as "oral [[quinolone]]s could be considered an option for those with less severe manifestations".<ref name="pmid19160207">{{cite journal |author=Chavez-Tapia NC, Soares-Weiser K, Brezis M, Leibovici L |title=Antibiotics for spontaneous bacterial peritonitis in cirrhotic patients |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD002232 |year=2009 |pmid=19160207 |doi=10.1002/14651858.CD002232.pub2 |url=http://dx.doi.org/10.1002/14651858.CD002232.pub2 |issn=}}</ref> | The role of antibiotics is not clear as "oral [[quinolone]]s could be considered an option for those with less severe manifestations".<ref name="pmid19160207">{{cite journal |author=Chavez-Tapia NC, Soares-Weiser K, Brezis M, Leibovici L |title=Antibiotics for spontaneous bacterial peritonitis in cirrhotic patients |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD002232 |year=2009 |pmid=19160207 |doi=10.1002/14651858.CD002232.pub2 |url=http://dx.doi.org/10.1002/14651858.CD002232.pub2 |issn=}}</ref> | ||
===Oral treatment=== | |||
{| class="wikitable" | |||
|+ [[Randomized controlled trial]]s of oral antibiotics for non-severe spontaneous bacterial peritonitis<ref name="grange2004">Grange J. Randomized, comparative study of moxifloxacin versus amoxicillin-clavulanate in the treatment of bacterial infections in cirrhotic patients. Hepatology 2004;40(4 (Suppl 1)):631A.</ref><ref name="pmid14571754">{{cite journal| author=Tuncer I, Topcu N, Durmus A, Turkdogan MK| title=Oral ciprofloxacin versus intravenous cefotaxime and ceftriaxone in the treatment of spontaneous bacterial peritonitis. | journal=Hepatogastroenterology | year= 2003 Sep-Oct | volume= 50 | issue= 53 | pages= 1426-30 | pmid=14571754 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=14571754 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref><ref name="pmid10782908">{{cite journal| author=Ricart E, Soriano G, Novella MT, Ortiz J, Sàbat M, Kolle L et al.| title=Amoxicillin-clavulanic acid versus cefotaxime in the therapy of bacterial infections in cirrhotic patients. | journal=J Hepatol | year= 2000 | volume= 32 | issue= 4 | pages= 596-602 | pmid=10782908 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10782908 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref><ref name="pmid11059861">{{cite journal| author=Terg R, Cobas S, Fassio E, Landeira G, Ríos B, Vasen W et al.| title=Oral ciprofloxacin after a short course of intravenous ciprofloxacin in the treatment of spontaneous bacterial peritonitis: results of a multicenter, randomized study. | journal=J Hepatol | year= 2000 | volume= 33 | issue= 4 | pages= 564-9 | pmid=11059861 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11059861 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref><ref name="Figueiredo1997">Figueiredo FAF, Coelho HSM, Soares JAS, Salgueiro E, Pinto CA. Oral cephalosporin for the treatment of non-severe spontaneous bacterial peritonitis in liver disease: a prospective study of 38 cases [Cefalosporina oral para o tratamento da peritonite bacteriana espontanea nao complicada na cirrose hepatica: um estudo prospectivo de 38 casos]. GED - Gastrenterologia-Endoscopia-Digestiva 1997;16(6):231-6.</ref><ref name="navasa1996">Navasa M, Follo A, Llovet JM, Clemente G, Vargas V, Rimola A, et al.Randomized, comparative study of oral ofloxacin versus intravenous cefotaxime in spontaneous bacterial peritonitis. Gastroenterology 1996;111(4):1011-7. {{doi|10.1016/S0016-5085(96)70069-0}}</ref> | |||
! rowspan="2"|Trial!!rowspan="2"| Patients!!rowspan="2"| Comparison!!rowspan="2"|Outcome!!colspan="2"|Results | |||
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! Intervention!!Control | |||
|- | |||
| Grange<ref name="grange2004"/><br/>2004|| cell|| cell|| cell|| cell|| cell | |||
|- | |||
| Tuncer<ref name="pmid14571754"/><br/>2003 || cell|| oral ciprofloxacin versus IV cefotaxime with IV ceftriaxone|| cell|| cell|| cell | |||
|- | |||
| Ricart<ref name="pmid10782908"/><br/>2000|| cell|| cell|| cell|| cell|| cell | |||
|- | |||
| Terg<ref name="pmid11059861"/><br/>1997|| cell|| cell|| cell|| cell|| cell | |||
|- | |||
| Figueiredo<ref name="Figueiredo1997"/><br/>1996|| 38 patients|| oral versus IV cephalosporins|| cell|| cell|| cell | |||
|- | |||
| Navasa<br/>1996 || cell|| cell|| cell|| cell|| cell | |||
|} | |||
<references/> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 09:55, 6 September 2009
In medicine, spontaneous bacterial peritonitis is a form of peritonitis that occurs in patient with ascites.[1]
Etiology/cause
Proton pump inhibitors may be associated with SBP.[2]
Diagnosis
On physical examination, most patients have mild abdominal pain.[3]
The impression of the physician performing the physical examination may not be accurate:[3]
- sensitivity = 76%
- specificity = 34%
Regarding individual signs and symptoms:
- Fever over 100.4°on physical examination
- sensitivity = 18%
- specificity = 90%
- "Any abdominal pain or tenderness" on physical examination
- sensitivity = 94%
- specificity = 15%
Treatment
The role of antibiotics is not clear as "oral quinolones could be considered an option for those with less severe manifestations".[4]
Oral treatment
| Trial | Patients | Comparison | Outcome | Results | |
|---|---|---|---|---|---|
| Intervention | Control | ||||
| Grange[5] 2004 |
cell | cell | cell | cell | cell |
| Tuncer[6] 2003 |
cell | oral ciprofloxacin versus IV cefotaxime with IV ceftriaxone | cell | cell | cell |
| Ricart[7] 2000 |
cell | cell | cell | cell | cell |
| Terg[8] 1997 |
cell | cell | cell | cell | cell |
| Figueiredo[9] 1996 |
38 patients | oral versus IV cephalosporins | cell | cell | cell |
| Navasa 1996 |
cell | cell | cell | cell | cell |
- ↑ ICD9: 567.23
- ↑ Bajaj JS, Zadvornova Y, Heuman DM, et al. (May 2009). "Association of proton pump inhibitor therapy with spontaneous bacterial peritonitis in cirrhotic patients with ascites". Am. J. Gastroenterol. 104 (5): 1130–4. DOI:10.1038/ajg.2009.80. PMID 19337238. Research Blogging.
- ↑ 3.0 3.1 Chinnock B, Afarian H, Minnigan H, Butler J, Hendey GW (September 2008). "Physician clinical impression does not rule out spontaneous bacterial peritonitis in patients undergoing emergency department paracentesis". Ann Emerg Med 52 (3): 268–73. DOI:10.1016/j.annemergmed.2008.02.016. PMID 18433932. Research Blogging.
- ↑ Chavez-Tapia NC, Soares-Weiser K, Brezis M, Leibovici L (2009). "Antibiotics for spontaneous bacterial peritonitis in cirrhotic patients". Cochrane Database Syst Rev (1): CD002232. DOI:10.1002/14651858.CD002232.pub2. PMID 19160207. Research Blogging.
- ↑ 5.0 5.1 Grange J. Randomized, comparative study of moxifloxacin versus amoxicillin-clavulanate in the treatment of bacterial infections in cirrhotic patients. Hepatology 2004;40(4 (Suppl 1)):631A.
- ↑ 6.0 6.1 Tuncer I, Topcu N, Durmus A, Turkdogan MK (2003 Sep-Oct). "Oral ciprofloxacin versus intravenous cefotaxime and ceftriaxone in the treatment of spontaneous bacterial peritonitis.". Hepatogastroenterology 50 (53): 1426-30. PMID 14571754.
- ↑ 7.0 7.1 Ricart E, Soriano G, Novella MT, Ortiz J, Sàbat M, Kolle L et al. (2000). "Amoxicillin-clavulanic acid versus cefotaxime in the therapy of bacterial infections in cirrhotic patients.". J Hepatol 32 (4): 596-602. PMID 10782908.
- ↑ 8.0 8.1 Terg R, Cobas S, Fassio E, Landeira G, Ríos B, Vasen W et al. (2000). "Oral ciprofloxacin after a short course of intravenous ciprofloxacin in the treatment of spontaneous bacterial peritonitis: results of a multicenter, randomized study.". J Hepatol 33 (4): 564-9. PMID 11059861.
- ↑ 9.0 9.1 Figueiredo FAF, Coelho HSM, Soares JAS, Salgueiro E, Pinto CA. Oral cephalosporin for the treatment of non-severe spontaneous bacterial peritonitis in liver disease: a prospective study of 38 cases [Cefalosporina oral para o tratamento da peritonite bacteriana espontanea nao complicada na cirrose hepatica: um estudo prospectivo de 38 casos]. GED - Gastrenterologia-Endoscopia-Digestiva 1997;16(6):231-6.