Use Initial Broad-Spectrum Antibiotics in Nosocomial Spontaneous Bacterial Peritonitis

Current guidelines for treatment of spontaneous bacterial peritonitis (SBP) recommend initiation of empirical antibiotic therapy with a third-generation cephalosporin after diagnosis. However, because the epidemiology of SBP has shifted during the past decade, and the prevalence of multidrug-resistant bacteria has increased in hospitals, the choice of empiric antibiotic may differ depending on whether SBP is community-acquired or nosocomial.

To compare the efficacy of a broad-spectrum antibiotic regimen with that of a third-generation cephalosporin in treating patients with nosocomial SBP, researchers randomized 32 patients admitted with cirrhosis and ascites who subsequently developed SBP (at least 72 hours after admission) to receive the b…