A team from Sao Paulo, Brazil, determined whether a short course of ceftriaxone was sufficient to cure spontaneous bacterial peritonitis (SBP) in cirrhotic patients.
A total of 33 cirrhotic patients (23 men; mean age, 45 years) with SBP were enrolled in the trial.
All were treated with ceftriaxone (1.0 g given intravenously) every 12 hours, for 5 days.
Some 21 variables were recorded to evaluate their relationship to the resolution of SBP.
The etiology of cirrhosis was alcoholic in 42% of the patients, and 82% of the patients belonged to Child-Pugh Class C. Hepatic encephalopathy was present in 39% of the patients.
The most frequent organism causing SBP was Escherichia coli (60%).
Resolution of SBP on day 5 of treatment was achieved in 73% of the patients. Total resolution of SBP after prolonged therapy with ceftriaxone or another agent, selected according to antibiotic susceptibility, was achieved in 94% of the patients.
The investigators found that hospital mortality was 12%.
Multivariate analysis showed no factor that was significantly related to the resolution of SBP. However, univariate analysis showed that renal impairment and positive culture tended to be related.
| Resolution of SBP on day 5 of treatment was achieved in 73% of the patients.
| Journal of Gastroenterology |
Alex Vianey Callado França, of the University of Campinas, Sao Paulo, concluded on behalf of fellow authors, "A short course (5 days) of ceftriaxone is useful therapy for SBP.
"If the polymorphonuclear differential count in ascitic fluid is less than 250 cells/mm3 on day 5 of treatment, the antibiotic can be discontinued."