Long-term prognosis of cirrhosis after spontaneous bacterial peritonitis treated with ceftriaxone

J Clin Gastroenterol. 2001 Oct;33(4):295-8. doi: 10.1097/00004836-200110000-00007.

Abstract

Spontaneous bacterial peritonitis (SBP) is a frequent infection in cirrhotic patients with ascites, with a poor prognosis. The aims of this study were to determine the long-term survival of cirrhotic patients with SBP treated with ceftriaxone and to identify predictive factors related to survival. We studied 47 first episodes of SBP treated with ceftriaxone with a mean follow-up of 272 days. Nineteen variables were recorded to evaluate their relation to survival. The most frequent organism that caused SBP was Escherichia coli (40%). Spontaneous bacterial peritonitis resolution was achieved in 67% of patients. After resolution, SBP recurrence was observed in 44% of patients. The cumulative probability of survival was 68.1% at 1 month and 30.8% at 6 months. After uni-and multivariate analyses of all cases, SBP resolution ( p = 0.0001) and international normalized ratio (INR) ( p = 0.0057) were found to be related to survival. Another analysis performed after SBP resolution and SBP recurrence showed that ascitic fluid-positive culture ( p = 0.0344) and INR ( p = 0.0218) had statistical significance as variables predictive of long-term survival. We conclude that the survival of cirrhotic patients is very short after the first episode of SBP, a fact probably related to advanced liver disease, as liver dysfunction (INR) is the most important factor related to long-term patient survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ascitic Fluid / microbiology
  • Bacterial Infections / diagnosis
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / mortality*
  • Ceftriaxone / therapeutic use*
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Cirrhosis / complications
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Peritonitis / drug therapy*
  • Peritonitis / etiology
  • Peritonitis / mortality*
  • Probability
  • Prospective Studies
  • Regression Analysis
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome

Substances

  • Ceftriaxone