Spontaneous bacterial peritonitis recurrence on norfloxacin secondary prophylaxis.

IF 1.1 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY
Athish Shetty, Rishi Raman, Vikas Pemmada, Balaji Musunuri, Shiran Shetty, C Ganesh Pai, Ganesh Bhat
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引用次数: 0

Abstract

Background and study aims: Secondary prophylaxis with norfloxacin reduces recurrence of spontaneous bacterial peritonitis (SBP) significantly. No data available from Asia-Pacific region about recurrence of SBP in these patients.

Patients and methods: In a retrospective cohort study, we assessed recurrence rate of SBP in patients on norfloxacin secondary prophylaxis. One year recurrence of SBP, its profile, response rate and risk factors for recurrence were assessed.

Results: A total of 112 patients were analysed. During first episode of SBP, culture positive rate was 39/112(34.8 %) and resistance to ceftriaxone was 51.2 %. Overall efficacy of ceftriaxone as first line antibiotic was 70.5 % (70/112), but only 49 % (19/39) among culture positive patients. E. coli is the commonest organism isolated (21/39, 53.8 %), MDR organism in 12.8 % (5/39). Cumulative incidence of SPB recurrence was 22.3 % (25/112) on norfloxacin secondary prophylaxis at 1 year. Culture positive rate in recurrent SBP was 48 % (12/25) and ceftriaxone resistance and MDR organism were seen in 66.6 % and 16.6 %. Overall response rate to ceftriaxone in recurrent SBP was 40 % (10/25) and 21 % (3/14) in culture positive patients. Risk factors for SBP recurrence were age, INR and albumin (p < 0.05). No increase cumulative incidence of death among patients with or without recurrence.

Conclusion: Despite recent changes in bacteriological profile in SBP, recurrence of SBP on norfloxacin prophylaxis remains low. In recurrent SBP, response to ceftriaxone is significantly lower than first episode and there is trend towards increase in MDR organism in culture positive patient receiving norfloxacin.

服用诺氟沙星二级预防药物后自发性细菌性腹膜炎复发。
背景和研究目的:使用诺氟沙星进行二级预防可显著降低自发性细菌性腹膜炎(SBP)的复发率。亚太地区尚无关于这些患者 SBP 复发情况的数据:在一项回顾性队列研究中,我们评估了接受诺氟沙星二级预防治疗的患者的 SBP 复发率。对 SBP 一年内的复发率、其概况、反应率和复发的风险因素进行了评估:共对 112 名患者进行了分析。在 SBP 首次发作期间,培养阳性率为 39/112(34.8%),头孢曲松耐药率为 51.2%。头孢曲松作为一线抗生素的总体疗效为 70.5%(70/112),但在培养阳性患者中的疗效仅为 49%(19/39)。大肠杆菌是最常见的分离菌(21/39,53.8%),MDR 菌占 12.8%(5/39)。接受诺氟沙星二级预防治疗 1 年后,SPB 复发的累积发生率为 22.3%(25/112)。复发SBP的培养阳性率为48%(12/25),头孢曲松耐药率和MDR菌耐药率分别为66.6%和16.6%。复发 SBP 患者对头孢曲松的总体应答率为 40%(10/25),培养阳性患者的应答率为 21%(3/14)。SBP复发的风险因素是年龄、INR和白蛋白(P 结论:尽管最近细菌学检测方法发生了变化,但SBP复发的风险因素仍然存在:尽管最近 SBP 的细菌学特征发生了变化,但服用诺氟沙星预防性治疗后 SBP 的复发率仍然很低。在复发的 SBP 患者中,头孢曲松的应答率明显低于首次发病者,而且在接受诺氟沙星治疗的培养阳性患者中,MDR 菌有增加的趋势。
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来源期刊
Arab Journal of Gastroenterology
Arab Journal of Gastroenterology Medicine-Gastroenterology
CiteScore
2.70
自引率
0.00%
发文量
52
期刊介绍: Arab Journal of Gastroenterology (AJG) publishes different studies related to the digestive system. It aims to be the foremost scientific peer reviewed journal encompassing diverse studies related to the digestive system and its disorders, and serving the Pan-Arab and wider community working on gastrointestinal disorders.
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