Ciprofloxacin and long-term prevention of spontaneous bacterial peritonitis: results of a prospective controlled trial*1

Rolachon, A; Cordier, Laurent; Bacq, Yannick; Nousbaum, Jean-Baptiste; Franza, Anne Minello; Paris, J. C.; Fratté, S.; Bohn, Benoit; Kitmacher, P.; Stahl, Jean-Paul; Zarski, Jean–Pierre

doi:10.1016/0270-9139(95)90626-6

Cited by 57 publications

(7 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The characteristics of all prospective studies are summarized in Appendix Table 2, Supplementary Digital Content 1, http://links.lww.com/CTG/A365 . Of those, 2 were not randomized ( 24 , 25 ), 3 did not provide separate data on patients with and without prior SBP ( 7 , 26 , 27 ), 1 did not provide data for patients while on prophylaxis (only 3 months after the end of prophylaxis) and no mean follow-up time was provided ( 28 ), and 3 studies did not use today's definition of SBP and data could not be retrieved otherwise ( 6 , 7 , 29 ). Detailed characteristics of the finally included 12 studies and their exclusion criteria are depicted in Appendix Tables 3 and 4, Supplementary Digital Content 1, http://links.lww.com/CTG/A365 .…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Norfloxacin Prophylaxis to Prevent Spontaneous Bacterial Peritonitis: A Systematic Review and Meta-Analysis

Mücke

Graf

et al. 2020

Clin Transl Gastroenterol

View full text Add to dashboard Cite

INTRODUCTION: With the emergence of multidrug-resistant organisms, the efficacy of antibiotic prophylaxis to prevent spontaneous bacterial peritonitis (SBP) has been debated. The aim of this study was to assess factors impacting effectiveness of SBP prophylaxis. METHODS: We searched PubMed, Embase, and the Cochrane Registry from inception to May 2019 to identify randomized controlled trials of patients with liver cirrhosis that assessed SBP occurrence/recurrence during antibiotic prophylaxis with the common antibiotic agents. Network meta-analysis was performed, pooling data with regard to incidence rate ratios (IRRs) of SBP, death, or extraperitoneal infections. RESULTS: Overall, 1,626 patients in 12 randomized controlled trials were included. During primary prophylaxis, the incidence rate of SBP and death in the norfloxacin-treated patients was 0.117 and 0.438 per patient-year, respectively, and IRRs of placebo vs norfloxacin were significantly higher (IRR 5.35, 95% confidence interval 1.99–14.38, P = 0.0009 for SBP and IRR 2.04, 95% confidence interval 1.20–3.44, P = 0.008 for death). The efficacy of norfloxacin to prevent SBP, but not death, decreased over time (annual percent change from 1992 to 2015 8.2%, P = 0.019), The positive treatment effect was lower in studies including patients with increased ascites protein ( P = 0.021) or exceedingly high serum bilirubin ( P = 0.012) levels. Norfloxacin was not superior to other antibiotics. The incidence rate of SBP was 2.5-fold higher in patients treated with norfloxacin as secondary compared with primary prophylaxis. No significant differences between treatment designs were observed in secondary prophylaxis. DISCUSSION: Norfloxacin remained superior to placebo in preventing SBP, yet the efficacy to prevent SBP, not death, decreased over time. Further studies to understand this phenomenon are urgently needed.

show abstract

Section: Resultsmentioning

confidence: 99%

Efficacy of Norfloxacin Prophylaxis to Prevent Spontaneous Bacterial Peritonitis: A Systematic Review and Meta-Analysis

Mücke

Graf

et al. 2020

Clin Transl Gastroenterol

View full text Add to dashboard Cite

show abstract

“…55 Six studies were included in their analyses. [56][57][58][59][60][61] The European Association for the Study of Liver (EASL) recommend primary prophylaxis with norfloxacin (400 mg/day) in patients with Child-Pugh score ≥9 and serum bilirubin ≥3 mg/dL, with either impaired renal function or hyponatraemia and ascitic fluid protein lower than 15 g/L. 47 The American Association for the Study of Liver Diseases (AASLD) also suggest that antibiotics for primary prophylaxis of SBP should be considered for people at high risk of developing this complication, which was defined as an ascitic fluid protein <1.5 g/dL together with impaired renal function or liver failure.…”

Section: Primary Prophylaxismentioning

confidence: 99%

Guidelines on the management of ascites in cirrhosis

Aithal

Palaniyappan

China

et al. 2020

Gut

332

275

View full text Add to dashboard Cite

The British Society of Gastroenterology in collaboration with British Association for the Study of the Liver has prepared this document. The aim of this guideline is to review and summarise the evidence that guides clinical diagnosis and management of ascites in patients with cirrhosis. Substantial advances have been made in this area since the publication of the last guideline in 2007. These guidelines are based on a comprehensive literature search and comprise systematic reviews in the key areas, including the diagnostic tests, diuretic use, therapeutic paracentesis, use of albumin, transjugular intrahepatic portosystemic stent shunt, spontaneous bacterial peritonitis and beta-blockers in patients with ascites. Where recent systematic reviews and meta-analysis are available, these have been updated with additional studies. In addition, the results of prospective and retrospective studies, evidence obtained from expert committee reports and, in some instances, reports from case series have been included. Where possible, judgement has been made on the quality of information used to generate the guidelines and the specific recommendations have been made according to the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE)’ system. These guidelines are intended to inform practising clinicians, and it is expected that these guidelines will be revised in 3 years’ time.

show abstract

“…Oral norfloxacin 400 mg or trimethoprim–sulfomethoxazole one tablet double strength daily is commonly used in the outpatient setting. [ 93 94 95 96 97 98 ] Dosages of ciprofloxacin 750 mg weekly is an alternative option for SBP prophylaxis. As there is a greater risk for development of bacterial resistance, we recommend the use of daily dosing over intermittent dosing.…”

Section: Spontaneous Bacterial Peritonitismentioning

confidence: 99%

Ascites and spontaneous bacterial peritonitis: Recommendations from two United States centers

Sundaram

Manne

Al‐Osaimi

2014

Saudi J Gastroenterol

View full text Add to dashboard Cite

Cirrhosis affects millions of people throughout the world. Two of the most serious complications of liver cirrhosis are ascites and spontaneous bacterial peritonitis (SBP). The development of ascites is related to the severity of portal hypertension and is an indicator of increased mortality. Although sodium restriction and diuretic therapy have proven effective, some patients may not respond appropriately or develop adverse reactions to diuretic therapy. In such cases, interventions such as transjugular intrahepatic portosystemic shunt (TIPS) placement are warranted. SBP is a complication of ascites that confers a very high mortality rate. Recognition and prompt treatment of this condition is essential to prevent serious morbidity and mortality. Initiation of prophylaxis in SBP remains controversial. Given the burden of liver cirrhosis on the health care system, ascites and SBP will continue to provide challenges for the primary care provider, hospitalist, internist, and gastroenterologist alike.

show abstract

Ciprofloxacin and long-term prevention of spontaneous bacterial peritonitis: results of a prospective controlled trial*1

Cited by 57 publications

References 19 publications

Efficacy of Norfloxacin Prophylaxis to Prevent Spontaneous Bacterial Peritonitis: A Systematic Review and Meta-Analysis

Efficacy of Norfloxacin Prophylaxis to Prevent Spontaneous Bacterial Peritonitis: A Systematic Review and Meta-Analysis

Guidelines on the management of ascites in cirrhosis

Ascites and spontaneous bacterial peritonitis: Recommendations from two United States centers

Contact Info

Product

Resources

About