A COMPARATIVE STUDY OF CEFOTAXIME VS MEROPENEM AS EMPIRICAL TREATMENT IN SPONTANEOUS BACTERIAL PERITONITIS

•Spontaneous Bacterial Peritonitis (SBP) is the most frequent and life-threatening infection in patients with liver cirrhosis requiring prompt recognition and treatment. Gram negative enteric bacteria are considered the most common pathogens responsible for SBP. Third generation cephalosporins are the recommended drugs for treating Spontaneous Bacterial Peritonitis empirically. Recent studies have shown that effectiveness of cephalosporins has decreased in community acquired and hospital acquired SBP. Meropenem is being used in treatment of drug resistant and hospital acquired SBP. This study aims to evaluate and compare the effectiveness of cefotaxime vs meropenem as empirical treatment in SBP

This study is hospital based clinical trial study at JLN hospital, Ajmer. SBP was diagnosed based on the presence of >250 polymorphonuclear cells (PMN)/mm3 in ascites in liver cirrhosis patients in the absence of an intra-abdominal source of infection or malignancy. 54 subjects will be taken in study and randomized into two groups. One group will be  given cefotaxime and another group meropenem. Efficacy of antibiotic therapy will be checked with follow-up paracentesis after 48 hours of initiation of empirical antibiotic treatment showing reduction in neutrophil count of at least 25% or decrease of peritoneal fluid PMN count to < 250 cells/ mm3 and negative previously positive ascitic fluid culture. Outcome of treatment will be compared in both groups.