What Causes SBP
- Gram-Negative Bacteria (50%)
- E.coli (37%)
- Gram-Positive Bacteria (50%)
- Strep pneumonia (10%)
- Other Strep
- Staphylococcus aureus
Treatment of SBP
- SPB has a high mortality rate. Start treatment immediately.
- If ascitic fluid polymorphonuclear cell count is less than 250, start antibiotics. Poor prognosis if bilirubin < 8, albumin < 2.5 or creatinine > 2.1
- Antibiotic therapy + albumin, 5-10 days (5 days just as effective as 10). Cefotaxime or ceftriaxone is the first line. You may use fluoroquinolones. Avoid aminoglycosides/
- In patients at high risk, prevention is needed. Ceftriaxone or norfloxacin.