Abstract
Background/purpose of the studySpontaneous bacterial peritonitis (SBP) is a cause of significantly higher morbidity and mortality in patients with cirrhosis. This study was conducted to assess the effect of adding rifaximin to cefotaxime in treatment of SBP.Materials and methodsThe study was a prospective one that involved 98 patients with cirrhosis with SBP, who were divided randomly into two equal groups. Patients in group I received cefotaxime, whereas patients in group II received a combination of cefotaxime and rifaximin. Patients were evaluated clinically, and diagnostic aspiration was repeated on the third day of antibiotic therapy.ResultsBoth groups showed significant reduction in white blood cells on the third day compared with the first day (P<0.0001). Polymorphonuclear leukocyte count in ascetic fluid in both groups showed significant reduction on the third day compared with the first day, and the reduction was statistically significant in group II compared with group I (P<0.0001). One the third day of therapy, serum creatinine levels in group I and group II were 1.61±0.19 and 1.28±0.37, respectively. Both groups showed significant decrease in serum creatinine level. The reduction in group II compared with group I was statistically significant, with P value less than 0.0001.ConclusionRifaximin plus cefotaxime showed some favorable effects in treatment of SBP than cefotaxime alone. However, the clinical effects of these effects need to be clarified in further studies.
Highlights
Spontaneous bacterial peritonitis (SBP) is a serious infection caused by bacteria in patients with cirrhosis and is associated with significant high mortality [1]
The aim of the study was assessing the effect of adding rifaximin to cefotaxime in treatment of SBP compared with the use of cefotaxime alone
The remaining nine (9.18%) patients were negative for hepatitis C virus (HCV) and hepatitis B virus (HBV)
Summary
Spontaneous bacterial peritonitis (SBP) is a serious infection caused by bacteria in patients with cirrhosis and is associated with significant high mortality [1]. Small intestinal bacterial overgrowth has a significant role in the evolvement of SBP. Dysmotility of the small intestinal and bacterial overgrowth are frequent findings in hepatic patients with advanced liver cell failure and mostly contribute to increase in the number of enteric microorganisms reaching to the systemic circulation translocated from the intestinal wall [3,4]. Patients with cirrhosis showed increased access of intestinal bacteria to the portal circulation and these translocated bacteria and resultant cytokines are less likely to be cleared by the liver because of impaired phagocytic function of reticuloendothelial cells and increased collateral blood flow. Patients with liver cirrhosis have immunodeficiency [5], with impaired ability to clear the translocated bacteria
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
