This article summarizes a systematic review and meta-analysis conducted by Song et al. on the effectiveness of norfloxacin and alternative antibiotics for prophylaxis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. SBP is a life-threatening complication of cirrhosis, and the efficacy of norfloxacin in preventing SBP is declining due to bacterial resistance.
The researchers conducted a thorough search in PubMed, Embase, and Cochrane Library Databases and identified eight relevant randomized control trials (RCTs) involving 1,043 cirrhotic patients. They compared the impact of norfloxacin with alternative antibiotics in preventing SBP.
The results showed that both norfloxacin and alternative antibiotics demonstrated similar effectiveness in SBP prophylaxis, survival benefit, overall infection prevention, and safety. However, subgroup analyses revealed that rifaximin prophylaxis was associated with a decreased recurrence of SBP and fewer adverse events compared to norfloxacin. Despite this, rifaximin did not improve overall survival compared to norfloxacin.
Based on these findings, the researchers concluded that rifaximin could be considered a reasonable alternative to norfloxacin for SBP prophylaxis due to its better protective effect and safety profile.
This study provides important insights into the use of alternative antibiotics for preventing SBP in cirrhotic patients. It highlights the need to explore different options in order to combat the declining efficacy of norfloxacin. The findings contribute to the existing knowledge in the field and may guide clinical decision-making in the management of SBP in cirrhotic patients.
Definitions:
1. Spontaneous bacterial peritonitis (SBP): a life-threatening infection of the peritoneal cavity in patients with cirrhosis.
2. Cirrhosis: a chronic liver disease characterized by the replacement of liver tissue with scar tissue, leading to a decrease in liver function.
Sources:
Song et al. “Norfloxacin versus alternative antibiotics for prophylaxis of spontaneous bacterial peritonitis in cirrhosis: a systematic review and meta-analysis.” Infectious Disease. August 2023.
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