DIFFERENCE BETWEEN ORAL VERSUS INTRAVENOUS MEDICINE IN TREATMENT OF SPONTANEOUS BACTERIAL PERITONITIS
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Keywords
Systematic & individual, IV therapy
Abstract
Background: Spontaneous Bacterial Peritonitis (SBP) is a life-threatening infection in cirrhotics that necessitates prompt antibiotic use. The primary goal of this meta-analysis was to compare the efficacy of oral and IV antibiotics in SBP.
Objectives: We sought to compare oral versus intravenous antibiotic therapy in the treatment of SBP concerning efficacy, safety, and cost-effectiveness from a Retrospective cohort study
Study design: Retrospective cohort study
Place and Duration of Study: A tertiary care Hospital in Peshawar from Jan 2023 to Jan 2024
Methods: A Retrospective Cohort Study was performed at Tertiary Care Hospital Peshawar, including all patients who were diagnosed with SBP between January 2023 and January 2024. All patients were divided into two groups according to the antibiotics used: Group A -oral antibiotics and ciprofloxacin/cotrimoxazole with norfloxacin (patient 44); Group B- who needs I.V.I.V.I.V., cephalosporines, or ampicillin (patients). Patients were considered for inclusion if they were 18 years or older. They had a diagnosed hospital-acquired SBP based on an ascitic PMN cell count ≥250 cells/mm³ with positive bacterial cultures. Exclusion criteria were secondary peritonitis and severe co-morbid conditions necessitating non-study antibiotic treatment.
Results: In the oral metronidazole group (Group B), there was an 85% resolution rate, and in-hospital Mortality and duration of hospital stay were found to be a maximum of 10% and 7 ±3 days, respectively. Group B had a 90% resolution rate, and the general mortality rate was about 8 %, requiring hospitalization of only ten (±4) days. Group A 15% recurrences Group B 12% recurrences
Conclusion: If treated orally for SBP, oral antibiotics are no different statistically than IV regarding Mortality or LOS in the hospital. The demonstrated results support the introduction of oral treatment in those eligible to enhance adherence and decrease cost.
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Sayyeda Aisha Bahar
TMO Medicine, Ayub Teaching Hospital, Abbottabad, KPK Pakistan
Aqsa Amjad
TMO Medicine, Combined Military Hospital, Peshawar, KPK Pakistan
Adil Jan
TMO Surgery, Khyber Teaching Hospital, Peshawar, KPK Pakistan
Asif Wakil
TMO Paeds, Combined Military Hospital, Abbottabad, KPK Pakistan
Saad Manan
Medical Officer, Bangash Medical Center, Hangu KPK Pakistan
Adil Shah
TMO Paeds, Combined Military Hospital, Peshawar, KPK Pakistan
Roohi Saleh
TMO Medicine, Combined Military Hospital, Peshawar, KPK Pakistan