SynthesisClinical and translational gastroenterology2020
Efficacy of Norfloxacin Prophylaxis to Prevent Spontaneous Bacterial Peritonitis: A Systematic Review and Meta-Analysis.
Synthesis in Clinical and translational gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Norfloxacin versus alternative antibiotics for prophylaxis of spontaneous bacteria peritonitis in cirrhosis: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Comparison ofGastroenterology research · 2026Article
- KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications 2026.Clinical and molecular hepatology · 2026Article
- Temporal changes in etiology, complications, and infection-related admissions among patients with cirrhosis: a 20-year single-center study.Frontiers in medicine · 2026Article
- Fluoroquinolones for the Prophylaxis of Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis: Are They Losing Ground?Life (Basel, Switzerland) · 2025Review
- Impact of Quinolone Prophylaxis on Spontaneous Bacterial Peritonitis and Mortality in Cirrhosis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.JGH open : an open access journal of gastroenterology and hepatology · 2025Review
- Role of Rifaximin in the Prognosis of Critically Ill Patients with Liver Cirrhosis.Antibiotics (Basel, Switzerland) · 2025Article
- A Machine Learning Algorithm Avoids Unnecessary Paracentesis for Exclusion of SBP in Cirrhosis in Resource-limited Settings.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Multidrug-resistant bacterial infections in the liver transplant setting.Updates in surgery · 2024Review
- Bacterial Infections in Acute-on-chronic Liver Failure: Epidemiology, Diagnosis, Pathogenesis, and Management.Journal of clinical and translational hepatology · 2024Review
- Article
- Outcomes in patients with spontaneous bacterial peritonitis utilizing first-line or alternative agents for secondary prophylaxis.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2023Article
- Antibiotics in Chronic Liver Disease and Their Effects on Gut Microbiota.Antibiotics (Basel, Switzerland) · 2023Review
- Gut-liver axis: barriers and functional circuits.Nature reviews. Gastroenterology & hepatology · 2023Review
- Synthesis of New Norfloxacin-Tin Complexes to Mitigate the Effect of Ultraviolet-Visible Irradiation in Polyvinyl Chloride Films.Polymers · 2022Article
- Impact of colonization with multidrug-resistant organisms on antibiotic prophylaxis in patients with cirrhosis and variceal bleeding.PloS one · 2022Article
- Prevention of Cirrhosis Complications: Looking for Potential Disease Modifying Agents.Journal of clinical medicine · 2021Review
- Antibiotic prophylaxis in patients with cirrhosis: Current evidence for clinical practice.World journal of hepatology · 2021Review
- Stool and sputum microbiome during quinolone prophylaxis of spontaneous bacterial peritonitis: an exploratory study.Gut pathogens · 2020Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWith the emergence of multidrug-resistant organisms, the efficacy of antibiotic prophylaxis to prevent spontaneous bacterial peritonitis (SBP) has been debated. The aim of this study was to assess factors impacting effectiveness of SBP prophylaxis.
methodsWe searched PubMed, Embase, and the Cochrane Registry from inception to May 2019 to identify randomized controlled trials of patients with liver cirrhosis that assessed SBP occurrence/recurrence during antibiotic prophylaxis with the common antibiotic agents. Network meta-analysis was performed, pooling data with regard to incidence rate ratios (IRRs) of SBP, death, or extraperitoneal infections.
resultsOverall, 1,626 patients in 12 randomized controlled trials were included. During primary prophylaxis, the incidence rate of SBP and death in the norfloxacin-treated patients was 0.117 and 0.438 per patient-year, respectively, and IRRs of placebo vs norfloxacin were significantly higher (IRR 5.35, 95% confidence interval 1.99-14.38, P = 0.0009 for SBP and IRR 2.04, 95% confidence interval 1.20-3.44, P = 0.008 for death). The efficacy of norfloxacin to prevent SBP, but not death, decreased over time (annual percent change from 1992 to 2015 8.2%, P = 0.019), The positive treatment effect was lower in studies including patients with increased ascites protein (P = 0.021) or exceedingly high serum bilirubin (P = 0.012) levels. Norfloxacin was not superior to other antibiotics. The incidence rate of SBP was 2.5-fold higher in patients treated with norfloxacin as secondary compared with primary prophylaxis. No significant differences between treatment designs were observed in secondary prophylaxis. DISCUSSION: Norfloxacin remained superior to placebo in preventing SBP, yet the efficacy to prevent SBP, not death, decreased over time. Further studies to understand this phenomenon are urgently needed.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.