SPONTANEOUS BACTERIAL PERITONITIS - DETECTION, TREATMENT AND PROPHYLAXIS IN PATIENTS WITH LIVER-CIRRHOSIS

Spontaneous bacterial peritonitis (SBP) is a common complication in pa tients with liver cirrhosis and ascites. When a patient with liver cir rhosis and ascites presents with fever and/or abdominal pain, or a ten der abdomen on physical examination, or with refractory ascites, an as citic fluid aspirate should be obtained for culture and leucocyte coun t, The diagnosis of SEP is mainly based on the number of leucocytes or neutrophils in the ascitic fluid. Third-generation cephalosporins are the drugs of choice in the treatment of this disease. Since the recur rence rate is high, and in patients with decompensated liver cirrhosis associated with a definite mortality, prophylactic antibiotic therapy is indicated after a first episode of SEP. (C) 1997 Elsevier Science B.V.