Spontaneous Bacterial Peritonitis (SBP)

Duration

5-7 days

First Line

Therapy

Ceftriaxone 2g IV 24 hourly

Or, in Immediate (type 1) beta-lactam sensitivity

Therapy

Vancomycin IV (dosing as per guidelines. Use vancomycin calculator)

+

Ciprofloxacin oral 500mg 12 hourly (IV if enteral route unavailable).

Consult Microbiologist if patient has been receiving a quinolone as SBP prophylaxis.

Prophylaxis of Spontaneous Bacterial Peritonitis

Therapy

Co-Trimoxazole 960mg oral daily.

If alternative regimen required, discuss with Consultant Microbiologist

Notes

Fluroquinolones

Refer to important safety information for all quinolones prior to prescribing.

See MHRA Drug Safety Update January 2024: Fluoroquinolones must only be used in situations when other antibiotics, that are commonly recommended for the infection, are inappropriate such as:

  • there is resistance to other first-line antibiotics recommended for the infection
  • other first-line antibiotics are contraindicated in an individual patient
  • other first-line antibiotics have caused side effects in the patient requiring treatment to be stopped
  • treatment with other first-line antibiotics has failed