COMPARISON OF IV CIPROFLOXACIN VERSUS IV CEFTRIAXONE IN THE MANAGEMENT OF SPONTANEOUS BACTERIAL PERITONITIS IN LIVER CIRRHOSIS

Abstract

Objective: To compare the effects of intravenous ceftriaxone and intravenous ciprofloxacin on spontaneous bacterial peritonitis (SBP) among patients with liver cirrhosis.

Study Design: Quasi-experimental study

Place and Duration of Study: Department of  General Medicine , Pak Emirates Military Hospital (PEMH) Rawalpindi from 01 February 2024 to 31 July 2024.

Methodology: A total of 120 cirrhotic patients diagnosed with SBP were included in the study through a non-probability consecutive sampling technique. The patients were randomly assigned to two equal groups. Group A was administered intravenous ciprofloxacin, while Group B was given intravenous ceftriaxone. The efficacy of treatment was evaluated by a repeat ascitic fluid PMN count on the fifth day. Secondary outcomes comprised the emergence of hepatorenal syndrome, length of hospital stay, and in-hospital mortality. Data were evaluated with SPSS version 27.0. Chi-square and independent sample t-tests were employed, with p≤0.05 deemed statistically significant.

Results: The ceftriaxone group had a significantly better treatment efficacy than the ciprofloxacin group (81.7% vs. 53.3%, p=0.001). Ceftriaxone was associated with the occurrence of hepatorenal syndrome in only a small percentage of cases (10.0% vs. 48.3%, p<0.001). The mean duration of hospitalization was shorter with ceftriaxone (6.55±1.40 days vs. 9.86±1.98 days, p<0.001). In-hospital death rates were lower in patients treated with ceftriaxone but the difference was not considered statistically significant (11.7% vs. 23.3%, p=0.093).

Conclusion: For the treatment of spontaneous bacterial peritonitis in cirrhotic patients, intravenous ceftriaxone is the better option compared to ciprofloxacin.