Antibacterial therapy in the treatment of ascites peritonitis in liver cirrhosis

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Abstract

Ascites-peritonitis is a severe complication in patients with decompensated cirrhosis. The effectiveness of treatment of ascites of peritonitis depends largely on its early diagnosis. The main component of the treatment of ascites-peritonitis – a complex and targeted antibiotic therapy. Third-generation cephalosporins are recommended as empirical antibiotic therapy. The article presents the results of treatment of ascites peritonitis depending on the method of administration of antibacterial drug – cefbactam. The drug was administered in three ways: intravenous, endolymphatic and combined. The results of pharmacokinetics of the drug depending on the method of administration, as well as the results of the effectiveness of the antibacterial effect in the compared groups of patients.

About the authors

Sergey Ya. Ivanusa

S.M. Kirov Military Medical Academy

Author for correspondence.
Email: gensurg@yandex.ru

Dr. Med. Sci. Professor, Head, Department of General Surgery

Russian Federation, St. Petersburg

Igor Ev. Onnitsev

S.M. Kirov Military Medical Academy

Email: ionnicev@mail.ru

PhD, Postgraduate Student, Department of General Surgery

Russian Federation, St. Petersburg

Alexey V. Khokhlov

S.M. Kirov Military Medical Academy

Email: gensurg@yandex.ru

Dr. Med. Sci. Professor, Department of General Surgery

Russian Federation, St. Petersburg

Petr N. Zubarev

S.M. Kirov Military Medical Academy

Email: gensurg@yandex.ru

Dr. Med. Sci. Professor, Department of General Surgery

Russian Federation, St. Petersburg

Alexander V. Yankovsky

S.M. Kirov Military Medical Academy

Email: yankovskii-aleks@mail.ru

Postgraduate Student, Department of General Surgery

Russian Federation, St. Petersburg

Sergey A. Bugaev

S.M. Kirov Military Medical Academy

Email: Bugaev@ixv.ru

PhD, Head of the Scientific and Organizational Center of Surgery

Russian Federation, St. Petersburg

References

  1. Бакулин И.Г., Варламичева А.А. Гепаторенальный синдром: практические рекомендации по диагностике и лечению // Альманах клинической медицины. - 2014. - № 33. - С. 23-31. [Bakulin IG, Varlamicheva AA. Hepatorenal syndrome: diagnostic and therapeutic management. Almanac of clinical medicine. 2014;(33):23-31. (In Russ.)]
  2. Бугаев С.А. Эндолимфатическое введение препаратов в комплексном лечении асцит-перитонита у больных циррозом печени // Сборник тезисов конференции «Актуальные вопросы хирургического лечения синдрома портальной гипертензии»; Санкт-Петербург, 24-25 ноября 1999 г. - СПб., 1999. - С. 33-34. [Bugaev SA. Endolimfaticheskoe vvedenie preparatov v kompleksnom lechenii astsit-peritonita u bol'nykh tsirrozom pecheni. In: Proceedings of the conference “Aktual'nye voprosy khirurgicheskogo lecheniya sindroma portal'noy gipertenzii”; Saint Petersburg, 24-25 Nov 1999. Saint Petersburg; 1999. p. 33-34. (In Russ.)]
  3. Гостищев В.К., Сажин В.П., Авдовенко А.Л. Перитонит. - М.: ГЭОТАР-МЕД, 2002. [Gostishchev VK, Sazhin VP, Avdovenko AL. Peritonit. Moscow: GEOTAR-MED; 2002. (In Russ.)]
  4. Ерюхин И.А., Шляпников С.А., Ефимова И.С. Перитонит и абдоминальный сепсис // Инфекции в хирургии. - 2004. - Т. 2. - № 1. - С. 2-7. [Eryukhin IA, Shlyapnikov SA, Efimova IS. Peritonit i abdominal'nyy sepsis. Infektsii v khirurgii. 2004;1(2):2-7. (In Russ.)]
  5. Хохлов А. В. Хирургическое лечение резистентного асцита у больных циррозом печени: Дис.. д-ра мед. наук. - СПб., 2002. [Khokhlov AV. Khirurgicheskoe lechenie rezistentnogo astsita u bol'nykh tsirrozom pecheni. [dissertation] Saint Petersburg; 2002. (In Russ.)]
  6. Arroyo V, Gines P, Gerbes AL, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology. 1996;23(1):164-176. doi: 10.1002/hep.510230122.
  7. Chinnock B, Afarian H, Minnigan H, et al. Physician clinical impression does not rule out spontaneous bacterial peritonitis in patients undergoing emergency department paracentesis. Ann Emerg Med. 2008;52(3):268-273. doi: 10.1016/j.annemergmed.2008.02.016.
  8. Choi CH, Ahn SH, Kim DY, et al. Long-term clinical outcome of large volume paracentesis with intravenous albumin in patients with spontaneous bacterial peritonitis: a randomized prospective study. J Gastroenterol Hepatol. 2005;20(8): 1215-22. doi: 10.1111/j.1440-1746.2005.03861.x.
  9. European Association for the Study of the L. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53(3):397-417. doi: 10.1016/j.jhep.2010.05.004.
  10. Figueiredo FAF, Coelho HSM, Soares JAS. Peritonite bacteriana espontânea na cirrose hepática: prevalência, fatores preditivos e prognóstico. Rev Assoc Med Bras. 1999;45(2): 128-36. doi: 10.1590/s0104-42301999000200007.
  11. Piroth L, Pechinot A, Di Martino V, et al. Evolving epidemiology and antimicrobial resistance in spontaneous bacterial peritonitis: a two-year observational study. BMC Infect Dis. 2014;14:287. doi: 10.1186/1471-2334-14-287.
  12. Rimola A, García-Tsao G, Navasa M, et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. J Hepatol. 2000;32(1):142-153. doi: 10.1016/s0168-8278(00)80201-9.
  13. Riggio O, Angeloni S, Parente A, et al. Accuracy of the automated cell counters for management of spontaneous bacterial peritonitis. World Journal of Gastroenterology. 2008;14(37):5689. doi: 10.3748/wjg.14.5689.
  14. Runyon BA. Early events in spontaneous bacterial peritonitis. Gut. 2004;53(6):782-784. doi: 10.1136/gut.2003.035311.

Copyright (c) 2018 Ivanusa S.Y., Onnitsev I.E., Khokhlov A.V., Zubarev P.N., Yankovsky A.V., Bugaev S.A.

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