Antibiotic prophylaxis for patients with risk factors for spontaneous bacterial peritonitis (SBP) include:

  • Known history of SBP: Typically prolonged outpatient fluoroquinolone or TMP-SMX
  • Cirrhotic patients with GI bleed: Ceftriaxone 1q q24hrs [short-term]
  • Patients found to have ascites with ascitic total protein concentration <1.5g/dL or 15g/L [2,3,4]: Typically prolonged outpatient fluoroquinolone or TMP-SMX

REFERENCES

  1. Alaniz C, Regal RE. Spontaneous Bacterial Peritonitis: A Review of Treatment Options. Pharmacy and Therapeutics. 2009;34(4):204-210.
  2. Fernandez J, Navasa M, Planas R, et al. Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis. Gastroenterology 2007;133:818–824.74. 
  3. Terg R, Fassio E, Guevara M, et al. Ciprofloxacin in primary prophylaxis of spontaneous bacterial peritonitis: A randomized,placebo-controlled study. J Hepatol 2008;48:774–779.
  4. Llach J, Rimola A, Navasa M, et al. Incidence and predictivefactors of first episode of spontaneous bacterial peritonitis in cirrhosis with ascites: Relevance of ascitic fluid protein concentration. Hepatology. 1992;16:724–727.

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