Comparison of Efficacy of Intravenous Ciprofloxacin and Ceftriaxone in the Management of Spontaneous Bacterial Peritonitis in patient of Liver Cirrhosis

Abstract

Cirrhosis of liver is a very common problem that is associated with a very high mortality & morbidity in Pakistan. Liver cirrhosis is the result of liver cell damage that results in attempts at regeneration. This interplay of damage and repair leads to nodularity of liver. Spontaneous Bacterial Peritonitis is a serious and common complication requiring urgent treatment. It has deadly consequences if not treated immediately. Objective: Our objective was to compare the efficacy of intravenous ciprofloxacin and ceftriaxone in the management of spontaneous bacterial peritonitis (SBP) in patients of cirrhosis. Design: Randomized controlled trial. Setting: Medical Unit I, Allied Hospital, Faisalabad. Duration: 04-02-2013 to 03-08-2013. Methodology: Patients of liver cirrhosis who fulfilled the inclusion criteria were selected. Patients were divided randomly in two groups (Group A and B). In group A, 226 patients were given intravenous ciprofloxacin 200mg 12 hourly for 5 days and in group B 226 patients were given ceftriaxone 1g 12 hourly for 5 days and efficacy of treatment was determined by resolution of clinical symptoms, i.e. decrease in temperature, no abdominal pain, ascitic fluid examination after 5 days of treatment. Results: The mean age in group A was 49.9±9.2 years and in group B was 47.5±10.1 years. In group A, 110 (48.7%) were male patients and 116 (51.3%) were female patients. In group B 116 (51.3%) were male patients and 110 (48.7%) female patients. Treatment was efficacious 166(73.5%) patients in group A and 184(81.4%) patients in group B (p-value 0.055). Conclusion: It the conclusion of the study is that intravenous ciprofloxacin is as effective as ceftriaxone in the treatment of SBP in cirrhotic patients.