Daily Norfloxacin vs. Weekly Ciprofloxacin to Prevent Spontaneous Bacterial Peritonitis: A Randomized Controlled Trial
- Abstract
- OBJECTIVES: For the prevention of spontaneous bacterial peritonitis (SBP) in cirrhotic patients with ascites, norfloxacin 400 mg per day is recommended as a standard regimen. This study aims to investigate whether ciprofloxacin once weekly administration is not inferior to norfloxacin once daily administration for the prevention of SBP. METHODS: This is an investigator-initiated open-label randomized controlled trial conducted at seven tertiary hospitals in South Korea. Liver cirrhosis patients with ascites were screened, and enrolled in this randomized controlled trial if ascitic protein ≤1.5 g/dL or the presence of history of SBP. Ascitic polymorphonucleated cell count needed to be <250/mm(3). Patients were randomly assigned into norfloxacin daily or ciprofloxacin weekly group, and followed-up for 12 months. Primary endpoint was the prevention of SBP. RESULTS: One hundred twenty-four patients met enrollment criteria and were assigned into each group by 1:1 ratio (62:62). Seven patients in the norfloxacin group and five patients in the ciprofloxacin group were lost to follow-up. SBP developed in four patients (4/55) and in three patients (3/57) in each group, respectively (7.3% vs. 5.3%, P = 0.712). The transplant-free survival rates at 1 year were comparable between the groups (72.7% vs. 73.7%, P = 0.970). Incidence of infectious complication, hepatorenal syndrome, hepatic encephalopathy, and variceal bleeding rates were not significantly different (all P = ns). The factors related to survival were models representing underlying liver function. CONCLUSION: Once weekly ciprofloxacin was as effective as daily norfloxacin for the prevention of SBP in cirrhotic patients with ascites.
- All Author(s)
- H. J. Yim
; S. J. Suh
; Y. K. Jung
; S. Y. Yim
; Y. S. Seo
; Y. R. Lee
; S. Y. Park
; J. Y. Jang
; Y. S. Kim
; H. S. Kim
; B. I. Kim
; S. H. Um
- Issued Date
- 2018
- Type
- Article
- Keyword
- Adult; Aged; Anti-Bacterial Agents/administration & dosage/*therapeutic use; Ascites; Bacterial Infections/*drug therapy/prevention & control; Ciprofloxacin/administration & dosage/*therapeutic use; Disease-Free Survival; Drug Administration Schedule; Female; Gastrointestinal Hemorrhage/drug therapy/prevention & control; Humans; *Liver Cirrhosis; Male; Middle Aged; Norfloxacin/administration & dosage/*therapeutic use; Peritonitis/*drug therapy/prevention & control; Republic of Korea; Treatment Outcome; Young Adult
- Publisher
- American College of Gastroenterology
National Gastroenterological Association
- ISSN
- 0002-9270
- Citation Title
- The American Journal of Gastroenterology
- Citation Volume
- 113
- Citation Number
- 8
- Citation Start Page
- 1167
- Citation End Page
- 1176
- Language(ISO)
- eng
- DOI
- 10.1038/s41395-018-0168-7
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/1187
- 공개 및 라이선스
-
- 파일 목록
-
Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.