Treatment of Spontaneous Bacterial Peritonitis in Children Under 18 with Ascitic PMN Count >250/mm³

This protocol covers proven or suspected spontaneous bacterial peritonitis (SBP) in paediatric patients under 18 years of age, a population requiring specific clinical consideration. The diagnostic threshold and treatment approach are defined by ascitic fluid analysis.

Clinical Scenario Children aged under 18 with proven or suspected spontaneous bacterial peritonitis. Diagnosis is established by an ascitic fluid polymorphonuclear leukocyte (PMN) count >250/mm³. Treatment is also considered when diagnostic paracentesis cannot be achieved in a child with clinically suspected SBP.

Approach (partial) Management involves broad-spectrum antibiotic cover targeting both gram-positive and gram-negative organisms. The full agent selection, clinical algorithm, and complete regimen are available in the structured protocol below…

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References

DOI: 10.1002/hep.31884

The diagnosis of SBP is established with an ascites PMN count of >250/mm³.

Children with proven or suspected SBP should be treated with broad-spectrum antibiotic cover against both gram-positive and gram-negative organisms.

Broad-spectrum antibiotic coverage against both gram-positive and negative organisms should be commenced in children with ascites PMN count >250/mm³, or children with suspected SBP in whom diagnostic paracentesis cannot be achieved.

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