Schmid S A, Wiest R, Salzberger B, Klebl F
Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, Regensburg, Germany.
Med Klin Intensivmed Notfmed. 2012 Oct;107(7):548-52. doi: 10.1007/s00063-012-0084-3. Epub 2012 Mar 9.
Spontaneous bacterial peritonitis (SBP) is the most frequent infection in patients with cirrhosis during hospitalization and is associated with high acute and long-term mortality. Diagnosis is made by paracentesis with determination of neutrophil count in ascitic fluid. Empirical antibiotic therapy must be initiated immediately. The choice of drug is dependent on prior therapies. Liver transplantation has to be considered in the absence of contra-indications. Prophylaxis of SBP is indicated in patients with ascites and gastrointestinal hemorrhage, and in patients after SBP. Primary prophylaxis should be considered in high-risk patients with cirrhosis and ascites. The development of resistance to antibiotic drugs is a relevant side-effect.
自发性细菌性腹膜炎（SBP）是肝硬化患者住院期间最常见的感染，与高急性和长期死亡率相关。通过腹腔穿刺术测定腹水中性粒细胞计数进行诊断。必须立即开始经验性抗生素治疗。药物的选择取决于先前的治疗情况。在没有禁忌证的情况下，必须考虑肝移植。腹水和胃肠道出血患者以及SBP后患者需进行SBP预防。肝硬化和腹水的高危患者应考虑进行一级预防。抗生素耐药性的产生是一个相关的副作用。
