Profilaxis y tratamiento de la peritonitis bacteriana espontánea en el paciente cirrótico
- Barreales Valbuena, Mónica
- Muñoz Gómez, Raquel
- Fernández Vázquez, I.
ISSN: 0304-5412
Any de publicació: 2012
Títol de l'exemplar: Enfermedades del aparato digestivo (XI): enfermedades hepáticas, cirrosis hepática
Sèrie: 11
Número: 11
Pàgines: 671-674
Tipus: Article
Altres publicacions en: Medicine: Programa de Formación Médica Continuada Acreditado
Resum
Spontaneous bacterial peritonitis is a frequent and serious complication in patients with advanced liver cirrhosis and ascites. Early diagnosis, treatment and preventive measures have improved the prognosis in recent years. The diagnosis is based on the presence of high polymorphonuclear count in ascitic fluid. Early empiric antibiotic treatment should be instituted, with intravenous third generation cephalosporins in critically ill patients. In patients without evidence of renal or liver failure and without vomiting or ileus, oral antibiotics could be used as quinolones or amoxicillin/clavulanic acid. In addition, in selected cases at a high risk for renal failure, volume expansion with intravenous albumin is recommended. Prophylaxis is indicated in patients with an increased risk of spontaneous bacterial peritonitis: those who have recovered from a previous episode, patients with gastrointestinal bleeding and selected patients with low ascitic fluid protein and / or increased serum bilirubin.