Muhammad Khizer Hayat, Zahid Hussain Shah, Muhammad Fahr Hayat, Muhammad Yasir Imran, Irshad Hussain Qureshi.
Comparative study of Spontaneous Bacterial Peritonitis in Cirrhosis patients Managed with and without Proton Pump Inhibitors.
Pak J Med Health Sci Jan ;12(2):598-601.

Background: Spontaneous bacterial peritonitis (SBP) is one of the most serious complications of cirrhotic patients. A few studies have shown that use of proton pump inhibitors (PPI) may increase the risk of occurrence of SBP in cirrhotic patients. However, controversial results have been obtained in the last decades. Aim: To compare the frequency of Spontaneous Bacterial Peritonitis (SBP) with and without Proton Pump Inhibitors (PPI) in patients of cirrhosis with ascetic fluid. Study Design: Randomized controlled trial Settings: Department of Medicine, Mayo Hospital Lahore Duration: June 2016- December 2016 Methods: Two hundred patients fulfilling the selection were enrolled from Department of Medicine, Mayo Hospital Lahore after taking informed consent. Demographic data including name, age, gender and duration of cirrhosis was noted. Then patients were randomly divided in two groups by using lottery method. One group was given proton pump inhibitors along with standard therapy for a period of 3 months while the other group was given only standard therapy and followed over a period of 3 months. After 3 months, patients were again be evaluated and ascetic fluid was obtained through standard procedure. All samples collected were sent to the laboratory for confirmation of bacteria. Reports were assessed and patients were labeled as positive or negative for SBP . Results: In this study it was observed that patients who were using PPI among them frequency of SBP was 32% while those patients who were not using PPI among them frequency of SBP was 12% only. Use of PPI among patients presenting with liver cirrhosis had significantly higher rate for SBP. The same trend was seen in all age groups that patients on PPI had higher frequency for SBP but statistical significance was seen in patients in age group 31-40 years of age. Male and female patients and duration of disease showed the same trend that PPI users had higher frequency for SBP and statistically significance was not seen for female patients and patients with disease duration 7-10 years . Conclusion: PPI use was significantly associated with an increased overall risk of spontaneous bacterial peritonitis. So it is of core importance that PPIs should be used judiciously with regard to appropriate indications and duration in cirrhotic patients .

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com