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Spontaneous bacterial peritonitis recurrence in patients with cirrhosis receiving secondary prophylaxis with norfloxacin.
Marciano, Sebastián; Dirchwolf, Melisa; Diaz, Juan M; Bermudez, Carla; Gutierrez-Acevedo, Maria N; Barcán, Laura A; Smud, Astrid; Giunta, Diego; Gadano, Adrián C.
Afiliação
  • Marciano S; Liver Unit.
  • Dirchwolf M; Department of Research.
  • Diaz JM; Hepatology, Hepatobiliary Surgery and Liver Transplant Unit, Hospital Privado de Rosario, Rosario, Argentina.
  • Bermudez C; Liver Unit.
  • Gutierrez-Acevedo MN; Liver Unit.
  • Barcán LA; Liver Unit.
  • Smud A; Infectious Diseases Section, Department of Internal Medicine.
  • Giunta D; Infectious Diseases Section, Department of Internal Medicine.
  • Gadano AC; Department of Research.
Eur J Gastroenterol Hepatol ; 31(4): 540-546, 2019 04.
Article em En | MEDLINE | ID: mdl-30557229
ABSTRACT

OBJECTIVE:

Few studies carried out more than 20 years ago have evaluated spontaneous bacterial peritonitis (SBP) recurrence in patients receiving secondary antibiotic prophylaxis. These studies reported a 1-year recurrence rate of 20-26%. Changes in the bacteriology of SBP over the last few years might have negative effects on secondary prophylaxis. Our primary aim was to estimate the incidence of SBP recurrence in patients with cirrhosis receiving secondary prophylaxis with norfloxacin and to explore the factors associated with SBP recurrence. PATIENTS AND

METHODS:

This was a retrospective cohort study of patients receiving norfloxacin for the secondary prophylaxis of SBP from 1 March 2003 to 31 March 2016. Follow-up was performed for 365 days after secondary prophylaxis was started. A competing risk analysis approach was used.

RESULTS:

A total of 115 patients were included. The prevalence of quinolone-resistant and multiresistant bacteria in the first episode of SBP among patients with culture-positive SBP was 70.96% [95% confidence interval (CI) 51.96-85.77%] and 12.90% (95% CI 3.63-29.83%), respectively. The cumulative incidence of SBP recurrence was 28.53% (95% CI 20.15-37.45%) after 365 days. Male patients showed an estimated subhazard ratio of SBP recurrence of 2.52 (95% CI 1.07-5.91, P=0.034). No other risk factors for SBP recurrence were identified. The overall cumulative incidence of death after 365 days was 21.57% (95% CI 14.14-30.04%), without significant differences among patients with or without SBP recurrence.

CONCLUSION:

Even though changes in the bacteriology of SBP occurred over time, its recurrence rate in patients receiving norfloxacin remains similar to what was reported in the initial studies.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Peritonite / Infecções Bacterianas / Norfloxacino / Antibioticoprofilaxia / Cirrose Hepática / Antibacterianos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Gastroenterol Hepatol Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Peritonite / Infecções Bacterianas / Norfloxacino / Antibioticoprofilaxia / Cirrose Hepática / Antibacterianos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Gastroenterol Hepatol Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2019 Tipo de documento: Article