Epidemiology
- xxxx
Physiology
- xxx
Diagnosis
- Paracentesis
- WBC Count
- xxx
Clinical Manifestations
Gastrointestinal Manifestations
- Abdominal Pain (see Abdominal Pain, [[Abdominal Pain]])
Other Manifestations
- Fever (see Fever, [[Fever]])
- Leukocytosis (see Leukocytosis, [[Leukocytosis]])
- Sepsis (see Sepsis, [[Sepsis]])
Treatment
Antibiotics
- Importance of Prompt Antibiotic Therapy
- Delayed Antibiotic Therapy in SBP with Associated Septic Shock Significantly Increases the Mortality Rate (2015) [MEDLINE]
- Study: retrospective cohort study from an international, multicenter database (n = 126)
- Main Findings
- SBP with associated septic shock carries an 81.8% in-hospital mortality rate
- Each hour of delay in appropriate antimicrobial therapy is associated with a 1.86x increase in -inhospital mortality
- The admission APACHE II score, admission MELD score, and admission serum lactate are all positively correlated with the in-hospital mortality rate
- Earlier antibiotic initiation with appropriate antimicrobial therapy could significantly improve outcome
- Delayed Antibiotic Therapy in SBP with Associated Septic Shock Significantly Increases the Mortality Rate (2015) [MEDLINE]
Albumin (see Albumin, [[Albumin]])
-
Clinical Efficacy
- Trial of Albumin in Cirrhotics with SBP (NEJM, 1999) [MEDLINE]: in addition to antibiotics, intravenous albumin decreases the incidence of renal impairment and death, as compared to antibiotics alone
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xxx
- xxx
- xxx
Albumin
- Dosing: albumin 1.5 g/kg of body weight at the time of diagnosis, followed by 1 g/kg on day 3
- Clinical Efficacy: in combination with antibiotics, therapy, albumin as been demonstrated to decrease renal impairment and mortality rate [MEDLINE]
References
- Effect of Intravenous Albumin on Renal Impairment and Mortality in Patients with Cirrhosis and Spontaneous Bacterial Peritonitis. N Engl J Med 1999;341:403-9 [MEDLINE]
- Appropriate and timely antimicrobial therapy in cirrhotic patients with spontaneous bacterial peritonitis-associated septic shock: a retrospective cohort study. Aliment Pharmacol Ther. 2015 Apr;41(8):747-57. Epub 2015 Feb 20 [MEDLINE]