Weekly Ciprofloxacin vs. Daily Norfloxacin for Preventing Spontaneous Bacterial Peritonitis Recurrence

For treatment of spontaneous bacterial peritonitis (SBP) as a complication of ascites due to cirrhosis, the current standard of practice is to start daily antibiotics after the first episode of SBP to prevent recurrence. Although once-weekly ciprofloxacin has been shown to be effective in preventing recurrent SBP, no head-to-head comparison has been performed with daily antibiotics administration.

In an open-label, randomized, controlled trial, 124 patients with cirrhosis with ascites and history of previous SBP or presence of ascitic protein ≤1.5 g/dL were randomized to receive daily norfloxacin (400 mg) or weekly ciprofloxacin (750 mg) for 12 months. The primary endpoint was prevention of SBP (defined as the presence of ascitic polymorphon…