Spontaneous bacterial peritonitis. Detection, treatment and prophylaxis in patients with liver cirrhosis.

Spontaneous bacterial peritonitis (SBP) is a common complication in patients with liver cirrhosis and ascites. When a patient with liver cirrhosis and ascites presents with fever and/or abdominal pain, or a tender abdomen on physical examination, or with refractory ascites, an ascitic fluid aspirate should be obtained for culture and leucocyte count. The diagnosis of SBP is mainly based on the number of leucocytes or neutrophils in the ascitic fluid. Third-generation cephalosporins are the drugs of choice in the treatment of this disease. Since the recurrence rate is high, and in patients with decompensated liver cirrhosis associated with a definite mortality, prophylactic antibiotic therapy is indicated after a first episode of SBP.