Efficacy of antibiotics and influence factors in the treatment of 384 cases of liver cirrhosis complicated with nosocomial-acquired and community-acquired spontaneous bacterial peritonitis

Abstract

Objective To investigate the therapeutic efficacy of antibiotics and influence factors in the treatment of patients with liver cirrhosis complicated with nosocomial-acquired and community-acquired spontaneous bacterial peritonitis (SBP). Methods From August 2010 to March 2014, a total of 384 patients diagnosed with liver cirrhosis complicated with SBP were selected and divided into nosocomial-acquired and community-acquired groups. All the influence factors of patients were recorded and analyzed. Ascites was cultured and identified. According to the condition of patients, cefotaxime sodium, ceftriaxone sodium, levofloxacin, piperacillin-tazobactam, imipenem and cilastatin were administrated and the efficacy was determined. Chi square test or Logistic regression analysis was performed for statistical analysis. Results Among 384 patients with liver cirrhosis complicated with SBP, 264 were community-acquired SBP and 120 were nosocomial-acquired SBP. The efficacy rate of cefotaxime sodium, ceftriaxone sodium and levofloxacin in patients with initial treatment were 68.9% (62/90), 75.8% (72/95) and 61.4% (51/83), respectively; which was all lower than that of piperacillin-tazobactam (93.1%, 108/116), and the differences were statistically significant (χ2=20.600, 12.490 and 30.190, all P 0.05). Antibiotics used in the recent three months before onset of the disease and hospitalization history were the risk factors of ineffective treatment of cefotaxime sodium (χ2=16.972 and 12.429, both P<0.05), ceftriaxone sodium (χ2=20.564 and 5.764, both P<0.05) and levofloxacin (χ2=16.498 and 7.247, both P<0.05). Diabetes mellitus was the risk factor of ineffective treatment of cefotaxime sodium and ceftriaxone sodium (χ2=7.427 and 6.087, both P<0.05). Conclusions For patients with nosocomial-acquired SBP, the efficacy of piperacillin-tazobactam was better. Diabetes mellitus, previous use of antibiotics and hospitalization history were risk factors of ineffective treatment. Key words: Liver cirrhosis; Spontaneous bacterial peritonitis; Efficacy; Influence factor