علاج التهاب الصفاق البكتيري التلقائي لدى البالغين (العمر ≥18) مع العدوى المكتسبة من المجتمع

References

• The diagnosis of SBP/SBE is established with a fluid polymorphonuclear (PMN) leukocyte count >250/mm³.
• IV antibiotics should be started empirically (before obtaining culture results) in all patients with an ascites PMN count >250/mm³.
• First-line empirical antibiotic therapy for community-acquired SBP/SBE is IV third-generation cephalosporin.
• Currently, they are recommended as the first-line antibiotics (e.g., IV cefotaxime 2 g every 12 hours) in settings where MDROs are not prevalent (Table 9).
• The recommended duration of antibiotic therapy is 5⁠ – 7 days.
• Patients with SBP should be treated with IV albumin in addition to antibiotics (1.5 g/kg at day 1 and 1 g/kg at day 3).
• It is recommended that a diagnostic paracentesis be performed 48 hours after initiating antibiotic therapy to assess response.
• A negative response is defined by a decrease in PMN count <25% from baseline and should lead to broadening the antibiotic spectrum and investigating secondary peritonitis (abdominal imaging studies).