What antibiotics treat SBP?
What antibiotics treat SBP?
The empirical treatment of SBP consists of any of a number of cephalosporins, such as cefotaxime (Claforan), ceftriaxone (Rocephin), ceftizoxime (Cefizox), or amoxicillin–clavulanic acid (e.g., an IV formulation in Europe).
Is cefotaxime safe in liver disease?
Cefotaxime (CTX), a third-generation cephalosporin, has become one of the most widely used initial empiric therapies for SBP in cirrhosis [3]. It has been shown to be safe, effective, and well tolerated in a wide range of dosage and duration regimens [3–8].
What is the best antibiotic for peritonitis?
Cefotaxime is effective against 98% of causative organisms and is considered the treatment drug of choice. Anaerobic, pseudomonal, and staphylococcal coverage is not needed. Cefotaxime (2 g IV q8h) has been shown to achieve excellent ascitic fluid levels.
Who should get SBP prophylaxis?
Antibiotic prophylaxis for SBP should be given to persons with cirrhosis with a prior history of SBP or acute gastrointestinal bleeding, and should be considered in persons without a history of SBP who have renal and/or hepatic dysfunction—if the ascitic fluid total protein is less than 1.5 g/dL.
How long is SBP treated for?
For spontaneous bacterial peritonitis (SBP), a 10- to 14-day course of antibiotics is recommended. Although not required, a repeat peritoneal fluid analysis is recommended to verify declining PMN counts and sterilization of ascitic fluid.
Does cefepime cover SBP?
Conclusions: In hospitalized cirrhotics with SBP and risk factors for treatment failure, cefepime showed comparable efficacy and survival to imipenem. Non-response to therapy at 48 h is a reliable predictor of treatment failure and mortality. Antibiotic combinations and novel options are needed for these patients.
When should you suspect spontaneous bacterial peritonitis?
Spontaneous bacterial peritonitis (SBP) should be suspected in patients with cirrhosis who develop signs or symptoms such as fever, abdominal pain, altered mental status, abdominal tenderness, or hypotension (table 1).
