Digestive Diseases and Sciences

, Volume 55, Issue 4, pp 1149–1154

A Recent Evaluation of Empirical Cephalosporin Treatment and Antibiotic Resistance of Changing Bacterial Profiles in Spontaneous Bacterial Peritonitis

  • Tolga Yakar
  • Mustafa Güçlü
  • Ender Serin
  • Hikmet Alışkan
Original Article

DOI: 10.1007/s10620-009-0825-1

Cite this article as:
Yakar, T., Güçlü, M., Serin, E. et al. Dig Dis Sci (2010) 55: 1149. doi:10.1007/s10620-009-0825-1

Abstract

The aim of this research is to evaluate the recent changes in microorganisms causing spontaneous bacterial peritonitis in cirrhotic patients, antibiotic resistance, and response to empirical cephalosporin therapy. A total of 218 patients with ascites secondary to cirrhosis were enrolled. Parenteral cefotaxime or cefepime was given to patients who had a neutrophil count of 250/mm3 or more or a positive bacterial culture of ascitic fluid. Antibiotic failure was defined by an absence of clinical improvement and an insufficient decrease in neutrophil count of ascites (<25% of initial value) by the third day of therapy. Of all the patients, 44.6% had culture-negative neutrocytic ascites, 24.8% had spontaneous bacterial peritonitis, and 10.1% had monomicrobial nonneutrocytic bacterascites. Growth in culture was observed in 76 patients (34.9%). The two most common isolated bacteria were Escherichia coli (33.8%) and coagulase-negative Staphylococcus (CoNS; 19.7%). The two cephalosporins were effective against E. coli (82%) and but not against CoNS (44%), while levofloxacin showed reasonable activity against both E. coli (71%) and CoNS (90%) in vitro. We confirmed a recent increased incidence of spontaneous bacterial peritonitis caused by Gram-positive bacteria. Levofloxacin seems to be a good alternative treatment for patients with uncomplicated spontaneous ascites infections.

Keywords

Ascites Microbiology Escherichia coli Levofloxacin 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Tolga Yakar
    • 1
  • Mustafa Güçlü
    • 1
  • Ender Serin
    • 1
  • Hikmet Alışkan
    • 2
  1. 1.Department of Gastroenterology, Faculty of Medicine, Maremar Medical CenterBaskent UniversityAnkaraTurkey
  2. 2.Department of Microbiology, Faculty of MedicineBaskent UniversityAnkaraTurkey

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