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|Title:||Norfloxacin and trimethoprim-sulfamethoxazole therapy have similar efficacy in prevention of spontaneous bacterial peritonitis.|
|Authors:||Lontos, Steve;Gow, Paul J;Vaughan, Rhys B;Angus, Peter W|
Department of Gastroenterology and Hepatology, Austin Health, Melbourne, Australia
|Citation:||Journal of Gastroenterology and Hepatology 2007; 23(2): 252-5|
|Abstract:||Although norfloxacin (N) is widely accepted as the drug of choice for spontaneous bacterial peritonitis (SBP) prophylaxis, there is data to suggest that trimethoprim-sulfamethoxazole (TS) may be similarly effective. However, no studies have compared the efficacy and safety of N and TS in SBP prophylaxis. The aim of this retrospective analysis was to compare outcomes in patients who received either N or TS for the prevention of SBP.Records of all cirrhotic patients prescribed either N or TS for SBP prevention between April 2001 and May 2004 were reviewed. Data collected included age, sex, Child-Pugh score, ascitic protein concentration, etiology of liver disease, infections (SBP, bacteremia, and extraperitoneal infections), side-effects, and survival.Sixty-nine patients (18 female, 51 male), mean age 53.9 +/- 10.6 years, were prescribed N (n = 37) or TS (n = 32). The Child-Pugh score, model for end-stage liver disease score, and the prevalence of a low ascitic protein (<15 g/L) were similar between the groups (12.0 vs 12.4, 19.7 vs 18.2, and 78% vs 84%, respectively, P > 0.05). Fourteen (38%) infections occurred in the N group and 16 (50%) in the TS group (P > 0.05). Eight patients (21.6%) in the N group and nine (28%) in the TS group developed SBP (P > 0.05). The rates of liver transplantation (10 vs 13), adverse events (two in each group) and death (13 vs 14) were similar in the two treatment groups.Our findings suggest N and TS have similar efficacy in preventing SBP. This has significant implications for both the cost of SBP prophylaxis and the prevalence of fluoroquinolone resistance in patients with cirrhosis.|
|Internal ID Number:||17559367|
Anti-Bacterial Agents.adverse effects.therapeutic use
Anti-Infective Agents.adverse effects.therapeutic use
Norfloxacin.adverse effects.therapeutic use
Peritonitis.microbiology.mortality.prevention & control
Trimethoprim-Sulfamethoxazole Combination.adverse effects.therapeutic use
|Appears in Collections:||Journal articles|
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