CIPROFLOXACIN AND LONG-TERM PREVENTION OF SPONTANEOUS BACTERIAL PERITONITIS - RESULTS OF A PROSPECTIVE CONTROLLED TRIAL

The aim of this prospective double-blind study was to evaluate the val ue of long-term antibiotic prophylaxis using ciprofloxacin for the pre vention of spontaneous bacterial peritonitis (SEP) in 60 cirrhotic pat ients with low ascitic fluid protein levels (<15 g/L). The patients we re assigned to two groups: group I (n = 28) ciprofloxacin 750 mg per o s once a week for 6 months, group II (n = 32) placebo. The two groups were similar for clinical and laboratory characteristics. Twelve patie nts developed an intercurrent disorder, and 10 patients died during th e trial. There were no adverse effects in the treated group, There was a significant decrease in the incidence of SEP (3.6 vs, 22%) (P <.05) and duration of hospitalization (9.3 +/- 4.5 vs. 17.6 +/- 6.2 days) ( P <.05) in the treated group as compared with the placebo group. The b acteriological study showed no acquired resistance to ciprofloxacin af ter 6 months' treatment. These results suggest that long-term preventi ve antibiotic prophylaxis based on the weekly administration of 750 mg of ciprofloxacin is effective in the prevention of SEP in cirrhotic p atients.