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Title: Norfloxacin and trimethoprim-sulfamethoxazole therapy have similar efficacy in prevention of spontaneous bacterial peritonitis.
Austin Authors: Lontos, Steve;Gow, Paul J ;Vaughan, Rhys B ;Angus, Peter W 
Affiliation: Department of Gastroenterology and Hepatology, Austin Health, Melbourne, Australia
Issue Date: 7-Jun-2007
Publication information: 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.
Gov't Doc #: 17559367
DOI: 10.1111/j.1440-1746.2007.04926.x
Type: Journal Article
Subjects: Adult
Anti-Bacterial Agents.adverse effects.therapeutic use
Anti-Infective Agents.adverse effects.therapeutic use
Bacterial Infections
Middle Aged
Norfloxacin.adverse effects.therapeutic use
Peritonitis.microbiology.mortality.prevention & control
Retrospective Studies
Treatment Outcome
Trimethoprim-Sulfamethoxazole Combination.adverse effects.therapeutic use
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