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

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An Erratum to this article was published on 17 June 2009

An Erratum to this article was published on 17 June 2009

An Erratum to this article was published on 17 June 2009

An Erratum to this article was published on 17 June 2009

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.

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Authors and Affiliations

  1. Department of Gastroenterology, Faculty of Medicine, Maremar Medical Center, Baskent University, Ankara, Kahramanmaras, Turkey

    Tolga Yakar, Mustafa Güçlü & Ender Serin

  2. Department of Microbiology, Faculty of Medicine, Baskent University, Ankara, Turkey

    Hikmet Alışkan

Authors
  1. Tolga Yakar
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  2. Mustafa Güçlü
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  3. Ender Serin
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  4. Hikmet Alışkan
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Corresponding author

Correspondence to Mustafa Güçlü.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s10620-009-0868-3

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Yakar, T., Güçlü, M., Serin, E. et al. A Recent Evaluation of Empirical Cephalosporin Treatment and Antibiotic Resistance of Changing Bacterial Profiles in Spontaneous Bacterial Peritonitis. Dig Dis Sci 55, 1149–1154 (2010). https://doi.org/10.1007/s10620-009-0825-1

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  • DOI: https://doi.org/10.1007/s10620-009-0825-1

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