Oral ciprofloxacin after a short course of intravenous ciprofloxacin in the treatment of spontaneous bacterial peritonitis: results of a multicenter,randomized study

Background/Aims: Oral quinolones have been suggested as treatment of cirrho tic patients with uncomplicated spontaneous bacterial peritonitis. To evalu ate the efficacy of oral quinolones in all patients with this complication, oral ciprofloxacin after a short course of intraveneous (i.v.) ciprofloxac in was compared to i.v. ciprofloxacin. Methods: Eighty patients were allocated to receive ciprofloxacin i.v. 200 m g/12 h for 7 days (group A, n= 40) or i.v. 200 mg/12 h during 2 days follow ed by oral 500 mg/12 h for 5 days (group B, n=40). All patients with sponta neous bacterial peritonitis admitted to the hospital were included. Twenty- five variables obtained 48 h after treatment were introduced into univariat e and multivariate analyses to identify predictors of survival and outcome. Results: In the baseline condition, no differences were found between the t wo groups in clinical data, hepatic and renal function tests and Child Pugh score. The infection resolution rate was 76.3 % in group A and 78.4 % in g roup B, and hospital survival was 77.5 % in both groups. In multivariate an alysis serum creatinine and serum leukocytes 48 h after treatment were asso ciated with prognosis. Conclusions: Offal ciprofloxacin after a short course of i.v. ciprofloxacin is effective in the treatment of spontaneous bacterial peritonitis. This r egimen can be applied to all patients admitted to the hospital with this co mplication, and could be an alternative to treating these patients as outpa tients.