Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To compare the benefits and harms of different prophylactic antibiotic treatments for prevention of spontaneous bacterial peritonitis in people with liver cirrhosis.
Highlights
2.5% of all hospitalisations in people with liver cirrhosis are for spontaneous bacterial peritonitis
Based on very low-certainty evidence, there is considerable uncertainty about whether antibiotic prophylaxis is beneficial, and if beneficial, which antibiotic prophylaxis is most beneficial in people with cirrhosis and ascites with low protein or history of spontaneous bacterial peritonitis
Use of antibiotics to prevent spontaneous bacterial peritonitis in people with advanced liver disease What was the aim of this Cochrane Review?
Summary
2.5% of all hospitalisations in people with liver cirrhosis are for spontaneous bacterial peritonitis. Antibiotic prophylaxis forms the mainstay preventive method, but this has to be balanced against the development of drug-resistant spontaneous bacterial peritonitis, which is di icult to treat, and other adverse events. The major causes of liver cirrhosis include excessive alcohol consumption, viral hepatitis, non-alcohol related fatty liver disease, autoimmune liver diseases, and metabolic liver diseases (Williams 2014; Ratib 2015; Setiawan 2016). The major cause of complications and deaths in people with liver cirrhosis is due to the development of clinically significant portal hypertension (hepatic venous pressure gradient at least 10 mmHg) (de Franchis 2015). Decompensated cirrhosis is the most common indication for liver transplantation (Merion 2010; Adam 2012)
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