Preventing Spontaneous Bacterial Peritonitis in Cirrhotic Patients at High Risk

Cirrhotic patients with ascites who develop spontaneous bacterial peritonitis (SBP) have higher risk for uncontrolled infection and subsequent death than do patients who do not develop SBP. Although antibiotics lower risk for recurrent SBP, little information is available about their role in the primary prevention of SBP. Now, investigators in Spain have conducted a double-blind, randomized, placebo-controlled trial to evaluate the benefits of prophylactic norfloxacin (400 mg daily) in high-risk cirrhotic patients with ascites.

A total of 157 cirrhotic patients met the criteria for inclusion: low protein levels in the ascitic fluid (<15 g/L) and either severe liver failure (Child-Pugh score ≥9 with serum bilirubin level ≥3 mg/dL) or impaired…