Abdul Hanan, Muhammad Tahir, Shafique M.
Role of Intravenous Ciprofloxacin and Ceftriaxone in the Management of Spontaneous Bacterial Peritonitis Associated With Liver Cirrhosis.
Ann Pak Inst Med Sci Jan ;11(1):30-4.

Objective: To compare intravenous Quinolones (Ciprofloxacin) with Third Generation Cephalosporin (Ceftriaxone) in the management of Spontaneous Bacterial Peritonitis associated with Liver Cirrhosis. Methodology: This descriptive case series study was carried out in Fauji Foundation Hospital, Peshawar. A total of 174 patients of both genders with age ≥ 18 years diagnosed to have Cirrhosis due to Hepatitis C and B with Spontaneous Bacterial Peritonitis were included by purposive nonprobability sampling technique during a period of 10 months w. e. f January 13th to October 12th 2013. All patients underwent diagnostic Ascitic Fluid examination for diagnosis of Spontaneous Bacterial Peritonitis. The main test to diagnose Spontaneous Bacterial Peritonitis was Ascitic Fluid routine examination. Presence of > 250 PMN/mm3 was considered diagnostic of Spontaneous Bacterial Peritonitis overall. Results: A total of 174 patients were initially included in the study. Amongst these; 95 (54.6%) were male. The mean ± SD for age was 55.42 ± 9.42 ranging from 20 to 60 years. After 5 days treatment 167 (96%) patients resolved with treatment i.e., their Neutrophil Count dropped. Only 3 (1.7%) died; 2 in Ciprofloxacin Group and 1 in Ceftriaxone Group. 2 patients left against medical advice (LAMA) and 2 patients were resistant to treatment in Ciprofloxacin Group only. Conclusion: Spontaneous Bacterial Peritonitis is a very common problem in patients with Ascites due to Cirrhosis of liver. Early diagnosis and treatment plays a key role in decreasing mortality associated with Spontaneous Bacterial Peritonitis. We can conclude on the basis of this study that Flouroquinolones are as effective as 3rd generation Cephalosporin in resolving Spontaneous Bacterial Peritonitis.

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