Review article: spontaneous bacterial peritonitis – bacteriology, diagnosis, treatment, risk factors and prevention

ConclusionsThird‐generation, broad‐spectrum cephalosporins remain a good initial choice for SBP treatment. Levofloxacin is an acceptable alternative for patients not receiving long‐term flouroquinolone prophylaxis or for those with a penicillin allergy. For uncomplicated SBP, early oral switch therapy is reasonable. Alternative antibiotics such as pipercillin–tazobactam should be considered for patients with nosocomial SBP or for patients who fail to improve on traditional antibiotic regimens. Selective albumin supplementation remains an important adjunct in SBP treatment. Withholding acid suppressive medication deserves strong consideration, and discontinuing beta‐adrenergic antagonist therapy in patients with end‐stage liver disease and resistant ascites is standard care. Liver transplant evaluation should be undertaken for patients who develop SBP barring contraindications.

Source: Alimentary Pharmacology and Therapeutics - March 27, 2015 Category: Drugs & Pharmacology Authors: J. B. Dever, M. Y. Sheikh Tags: Review Article Source Type: research