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Spontaneous bacterial peritonitis (SBP)


Epidemiology of SBP

  • SBP occurs in 10-30% of patients with ascites and has mortality rate of 20%
  • Organisms are usually E. coli, streptococci and enterococci.


Symptoms of spontaneous bacterial peritonitis (SBP)

  • Generalised abdominal pain
  • Hepatic encephalopathy, renal impairment or peripheral leucocytosis without any obvious precipitating factor.


Video on the diagnosis and management of SBP


Investigations in suspected SBP


Treatment spontaneous bacterial peritonitis (SBP)

  • Prompt broad spectrum iv antibiotics
    • e.g. Tazocin 4.5g three times daily
    • Treat as soon as ascitic tap has been sent if high index for suspicion
  • If fluid resuscitation needed for septic shock then try to avoid colloid/crystalloid and use plasma expander such as human albumin solution instead.
  • Good evidence for prophylactic antibiotics after one episode of SBP
    • E.g. Ciprofloxacin 250mg twice daily


Click here to download free teaching notes on Decompensated chronic liver disease: Spontaneous bacterial peritonitis (SBP)

Perfect revision for medical students, finals, OSCEs and MRCP PACES