Spontaneous bacterial peritonitis natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2] Ahmed Younes M.B.B.CH [3]

Overview

Early diagnosis and initiating treatment is the most important factor for improving the survival and avoiding the complications of SBP. The sooner the diagnosis, the better the outcome.

Natural history

  • SBP is treatable with antibiotics but early diagnosis and intiation of empiric antibiotic therapy is the most important factor for survival.
  • In a study performed in 2006, Each hour of delay of administration of empiric antibiotics was associated with increased mortality by 7.6% while administration of antibiotics at the first hour of hypotension increased overall survival to 79%.[1]

Complications

The physician should have a high index of suspicion to diagnose SBP early and start empiric antibiotic therapy. The earlier the stage of diagnosis, the better the survival.

Hypotension, hypothermia and shock:

Altered mental status:

Paralytic ileus:

Diarrhea:

Prognosis

References

  1. Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Kumar A, Cheang M (2006). "Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock". Crit. Care Med. 34 (6): 1589–96. doi:10.1097/01.CCM.0000217961.75225.E9. PMID 16625125.
  2. Guarner C, Runyon BA, Young S, Heck M, Sheikh MY (1997). "Intestinal bacterial overgrowth and bacterial translocation in cirrhotic rats with ascites". J. Hepatol. 26 (6): 1372–8. PMID 9210626.
  3. Sundaram V, Manne V, Al-Osaimi AM (2014). "Ascites and spontaneous bacterial peritonitis: recommendations from two United States centers". Saudi J Gastroenterol. 20 (5): 279–87. doi:10.4103/1319-3767.141686. PMC 4196342. PMID 25253362.
  4. "Spontaneous bacterial peritonis - ScienceDirect".