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What is Prophylaxis against spontaneous bacterial peritonitis ( SBP) in case of cirrhosis with ascites is indicated in: and explain in detail?
The risk factors for SBP are 1.Ascitic fluid protein < 1 g/dl 2.Variceal hemorrhage 3.Prior episode of SBP Acute variceal bleeding patients need prophylaxis against SBP & Drugs used for prophylaxis are: 1.Inj.Ceftriaxone 1 g/day 2. Oral. Ofloxacin 400 mg/day or Norfloxacin 400 OD Primary prophylaxis is indicated in patients with features of : Ascitic fluid protein < 1.5 g/dl With at least one of the following 1. Serum creatinine > 1.2 mg/dl 2. BUN > 25 mg/dl 3. Serum Na < 130 mEq/L 4. CTP > 9 points with bilirubin > 3 mg/dl 5. DRug is Norfloxacin 400 mg OD for long time. Ref: AASLD practice guidelines:Hepatology, Vol.49 ,No.6 ,2009.