The usefulness of reagent strips to check cure of spontaneous bacterial peritonitis have not been evaluated to date.
Dr Castellote and colleagues from Spain aimed to assess the usefulness of ascitic fluid analysis by means of reagent strips to check cure after a 5-day antibiotic course.
The team prospectively included all cirrhotic patients diagnosed with spontaneous bacterial peritonitis.
|Spontaneous bacterial peritonitis had not resolved by day 5 in 20%.|
|Alimentary Pharmacology & Therapeutics|
On day 5, conventional and reagent strip ascitic fluid analyses were performed.
The researchers included 53 episodes of spontaneous bacterial peritonitis in 51 cirrhotic patients.
The research team found that 5 patients died before the 5th day and, in 2 patients, the control paracentesis yielded no ascitic fluid.
In 20% of cases, spontaneous bacterial peritonitis had not resolved by day 5.
In 32 out of 33 cases in which the ascitic fluid polymorphonuclear count was less than 250/µL at day 5, the reagent strips was negative.
The negative predictive value of the reagent strip at fifth day was 97%.
Dr Castellote's team concluded, “Almost 20% of episodes of spontaneous bacterial peritonitis do not resolve with a short-course of antibiotic treatment.”
“In view of the high negative predictive value and low likelihood ratio for a negative test, reagent strips analysis may be an alternative to conventional cytology if a 5-day antibiotic therapy is planned.”