In which high risk patient groups is prophylaxis against spontaneous bacterial peritonitis (SBP) indicated?

Updated: Nov 26, 2018
  • Author: Thomas E Green, DO, MPH, MMM, CPE, FACEP, FACOEP; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Outpatient prophylaxis, although not recommended routinely, has been shown to prevent spontaneous bacterial peritonitis in the following high-risk groups:

  • Patients with ascites admitted with acute GI bleeding

  • Patients with ascitic fluid protein levels of less than 1 g/dL

  • Patients with a prior episode of spontaneous bacterial peritonitis

Suggested outpatient prophylactic regimens include the following:

  • Norfloxacin - 400 mg daily

  • Ciprofloxacin - 750 mg weekly

  • Five doses of double-strength trimethoprim-sulfamethoxazole per week (Monday through Friday)


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