Spontaneous bacterial peritonitis in cirrhotic patients: Is prophylactic propranolol therapy beneficial?

Journal of Gastroenterology and Hepatology
Evangelos CholongitasAthanasios J Archimandritis

Abstract

It has been suggested that propranolol may have a protective effect on the development of spontaneous bacterial peritonitis by increasing the motility of the bowel and lowering the pressure of the portal vein. The aim of this study is to evaluate the association between the use of propranolol and development of spontaneous bacterial peritonitis in patients with cirrhosis and ascites. We retrospectively evaluated 134 patients with cirrhosis and ascites admitted consecutively for a period of 2 years. Diagnosis of spontaneous bacterial peritonitis was based on an ascitic fluid neutrophilic count of >250/mm3 and/or a positive culture without evidence of secondary peritonitis. Spontaneous bacterial peritonitis was diagnosed in 39 of 134 (29%) patients and 12 of 39 (31%) patients died in hospital compared to only 4% (four of 95) of those without spontaneous bacterial peritonitis (P < 0.001). At admission, patients with spontaneous bacterial peritonitis, as compared to those without, had significantly more encephalopathy (28 vs 11%, P = 0.02) or fever (18 vs 4%, P = 0.01) and less frequently tense ascites (33 vs 57%, P = 0.02). Spontaneous bacterial peritonitis was diagnosed in six of 33 (18%) patients who did and in 33 of 101 (33%) w...Continue Reading

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Citations

Jun 7, 2007·Postgraduate Medical Journal·A KoulaouzidisB D Linaker
Nov 19, 2011·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Mauro BernardiMahlon M Wilkes
Jun 11, 2009·Liver International : Official Journal of the International Association for the Study of the Liver·Marco SenzoloAndrew Kenneth Burroughs
May 20, 2014·Liver International : Official Journal of the International Association for the Study of the Liver·Manuela MerliMario Venditti
Feb 2, 2016·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Sakkarin ChirapongsathornPatrick S Kamath
Mar 25, 2006·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Evangelos B CholongitasAndrew K Burroughs
Jul 19, 2018·World Journal of Gastroenterology : WJG·Ioanna AggeletopoulouChristos Triantos
May 5, 2018·Digestive Diseases and Sciences·Antonio FacciorussoNicola Muscatiello

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