Peritonitis (SBP)

Question 1

What is spontaneous bacterial peritonitis (SBP)?

Answer 1

SBP is a form of peritonitis usually seen in patients with ascites secondary to liver cirrhosis.

Question 2

What are the features of SBP?

Answer 2

The features of SBP include ascites, abdominal pain, and fever.

Question 3

How is SBP diagnosed?

Answer 3

Diagnosis is made through paracentesis showing a neutrophil count > 250 cells/ul.

The most common organism found on ascitic fluid culture is E. coli.

Question 4

What is the management for SBP?

Answer 4

Intravenous cefotaxime is usually given.

Question 5

When should antibiotic prophylaxis be given to patients with ascites?

Answer 5

Prophylaxis should be given to patients who have had an episode of SBP or those with fluid protein <15 g/l and either a Child-Pugh score of at least 9 or hepatorenal syndrome.

Question 6

What does NICE recommend for antibiotic prophylaxis in patients with cirrhosis and ascites?

Answer 6

NICE recommends offering prophylactic oral ciprofloxacin or norfloxacin for people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less until the ascites has resolved.

Question 7

What is a marker of poor prognosis in SBP?

Answer 7

Alcoholic liver disease is a marker of poor prognosis in SBP.