Long-term prognosis of cirrhosis after spontaneous bacterial peritonitis treated with ceftriaxone

Spontaneous bacterial peritonitis (SBP) is a frequent infection in cirrhoti c patients with ascites, with a poor prognosis. The aims of this study were to determine the long-term survival of cirrhotic patients with SBP treated with ceftriaxone and to identify predictive factors related to survival. W e studied 47 first episodes of SBP treated with ceftriaxone with a mean fol low-up of 272 days. Nineteen variables were recorded to evaluate their rela tion to survival. The most frequent organism that caused SBP was Escherichi a coli (40%). Spontaneous bacterial peritonitis resolution was achieved in 67% of patients. After resolution, SBP recurrence was observed in 44% of pa tients. The cumulative probability of survival was 68.1% at 1 month and 30. 8% at 6 months. After uni- and multivariate analyses of all cases, SBP reso lution (p=0.0001) and international normalized ratio (INR) (p=0.0057) were found to be related to survival. Another analysis performed after SBP resol ution and SBP recurrence showed that ascitic fluid-positive culture (p=0.03 44) and INR (p=0.0218) had statistical significance as variables predictive of long-term survival. We conclude that the survival of cirrhotic patients is very short after the first episode of SBP, a fact probably related to a dvanced liver disease, as liver dysfunction (INR) is the most important fac tor related to long-term patient survival.