ArticleThe American journal of gastroenterology2019
Outcomes in Patients With Cirrhosis on Primary Compared to Secondary Prophylaxis for Spontaneous Bacterial Peritonitis.
Article in The American journal of gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 27 citations in OpenAlex.
- Review
- A National Survey Shows a Dilemma Toward Spontaneous Bacterial Peritonitis Prophylaxis Among US-Based Hepatology Professionals.Clinical and translational gastroenterology · 2025Article
- Prophylaxis for Spontaneous Bacterial Peritonitis.Gastroenterology & hepatology · 2025Article
- Article
- Norfloxacin prophylaxis effect on multidrug resistance in patients with cirrhosis and bacterial infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Article
- Challenges and recommendations when selecting empirical antibiotics in patients with cirrhosis.World journal of hepatology · 2023Review
- Prophylaxis against spontaneous bacterial peritonitis: Too much or too little?Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- Management of hepatorenal syndrome in liver cirrhosis: a recent update.Therapeutic advances in gastroenterology · 2022Review
- A Historical Overview of Spontaneous Bacterial Peritonitis: From Rare to Resistant.Clinical liver disease · 2021Review
- A Commentary on the Interplay Between Severity of Liver Disease and Bacterial Infection in Hospitalized Patients with Cirrhosis.Digestive diseases and sciences · 2021Article
- Underutilization of Hospice in Inpatients with Cirrhosis: The NACSELD Experience.Digestive diseases and sciences · 2020Article
- Antimicrobial resistance in chronic liver disease.Hepatology international · 2020Review
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Authors and funding
15 authors at 15 institutions in 2 countries.
Funding
Abstract
objectivesAntibiotic prophylaxis is recommended for prevention of the first episode of spontaneous bacterial peritonitis (SBP; primary prophylaxis 1°) and subsequent episodes (secondary prophylaxis 2°). We aimed to compare outcomes in cirrhotic inpatients on 1° vs 2° SBP prophylaxis.
methodsData from North American Consortium for the Study of End-Stage Liver Disease were evaluated for cirrhosis details, reasons for admission/medications, inpatient course recorded, and outcomes over 90 days. Outcomes (intensive care units, acute kidney injury, inpatient/90-day mortality) were compared between the 2 groups after propensity-matching on admission model for end-stage liver disease (MELD) score and serum albumin.
resultsAmong the 2,731 patients enrolled, 305 were on 1° and 187 on 2° SBP prophylaxis. After propensity-matching, 154 patients remained in each group. Patients on 1° prophylaxis were more likely to have admission systemic inflammatory response syndrome (P = 0.02), with higher intensive care unit admissions (31% vs 21%; P = 0.05) and inpatient mortality (19% vs 9%; P = 0.01) than the 2° prophylaxis group. Patients on 2° prophylaxis had higher total (22% vs 10%; P = 0004), readmission (16% vs 9%; P = 0.03), and nosocomial (6% vs 0.5%; P = 0.01) SBP rates with predominant Gram-negative organisms compared to 1° prophylaxis patients. At 90 days, 1° prophylaxis patients had a higher mortality (35% vs 22%; P = 0.02) and acute kidney injury incidence (48% vs 30%; P = 0.04) compared to 2° prophylaxis patients. DISCUSSION: In this inpatient cirrhosis study, despite prophylaxis, a high proportion of patients developed SBP, which was associated with mortality. Cirrhotic inpatients on 1° prophylaxis had worse outcomes than those on 2° prophylaxis when propensity-matched for the MELD score and serum albumin during the index admission and 90-day follow-up.
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