Spontaneous Bacterial Peritonitis (SBP)

Question 1

What is spontaneous bacterial peritonitis?

Answer 1

form of peritonitis usually seen in patients with ascites secondary to liver cirrhosis

Question 2

Features of SBP?

Answer 2

Ascites
Abdominal pain
Fever

Question 3

Diagnosis of SBP?

Answer 3

Paracentesis: procedure that removes fluid (peritoneal fluid) from the abdomen through a slender needle
Neutrophil count >250 cell/ul on paracentesis

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

Question 4

When should antibiotic prophylaxis be given to patients with ascites? and which antibiotics

Answer 4

1. patients who have had an episode of SBP
2. Patients with fluid protein <15 g/l and either Child-Pugh score of at least 9 or hepatorenal syndrome

NICE recommend: ‘Offer prophylacticoral ciprofloxacin or norfloxacinfor people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less until the ascites has resolved’