Background and objectives: Spontaneous bacterial peritonitis (SBP) is the infection of a previously sterile ascitic fluid, with no apparent intra-abdominal source of infection. Spontaneous bacterial peritonitis is a common complication in cirrhotic patients. The objectives of this study was to evaluate the prevalence, clinical profile, course, microbiology, response to treatment and outcome of SBP.
Materials and methods: The study was conducted at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow. Two hundred sixteen patients of cirrhosis of liver with ascites were taken for study. The duration of study was six months (January 2018 – June 2018). Diagnosis of cirrhosis of liver was made on basis of clinical presentation, routine biochemical and hematological blood investigations and ultrasound abdomen. Both old and newly diagnosed admitted cases of cirrhosis of liver with ascites were taken up for this study. Ascitic fluid analysis was done for all patients of cirrhosis at the time of admission. All patients of SBP who survived were put on prophylactic norfloxacin 400mg once daily therapy on discharge. Ascitic fluid analysis was repeated on all subsequent admissions.
Results: The prevalence of SBP in our admitted patients with cirrhosis and ascites was 18.52%. Only 6.6% of patients developed second episode of SBP on norfloxacin prophylaxis. The 30 day in hospital mortality attributable to SBP was 25%. Median survival of those who died were 11 days. Among patients who survived first episode of SBP and started on norfloxacin prophylaxis 70% required repeat hospitalization due to complications of cirrhosis within six months of first admission.
Conclusion: The present study showed that SBP is a common complication of Cirrhosis with ascites. Norfloxacin prophylaxis is associated with reduced recurrences of spontaneous bacterial peritonitis. Patients having SBP have poor survival and require repeated admission because of poor liver functions.
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2022: 6.012
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