Individual research recommendation details

Recommendation ID

NG50/6

Question

Antibiotic resistance in treating spontaneous bacterial peritonitis:- How frequently does antibiotic resistance occur, and how significant are antibiotic treatment-related complications when antibiotics are used for the primary prevention of spontaneous bacterial peritonitis in people at high risk of having, or developing, cirrhosis?

Any explanatory notes
(if applicable)

Why this is important:- Spontaneous bacterial peritonitis is the most common serious infection in people with cirrhosis, occurring in 25% of people who develop ascites. It is associated with significant morbidity and mortality rates of 20–40%. It occurs most commonly in people with advancing liver disease; approximately 70% of cases occur in people with Child-Pugh class C cirrhosis.
Several oral antibiotics that have been investigated for the prophylaxis of spontaneous bacterial peritonitis have shown benefits and a significant reduction in the incidence of spontaneous bacterial peritonitis in people at high risk of having, or developing, cirrhosis. However, they are associated with antibiotic resistance, adverse reactions and drug interactions. There is a lack of good quality, recent evidence regarding the prevalence and consequences of antibacterial resistance that may occur during long-term oral antibiotic therapy when used to prevent spontaneous bacterial peritonitis.

Source guidance details

Comes from guidance

Cirrhosis in over 16s: assessment and management

Number

NG50

Date issued

July 2016

Other details