SBP in the setting of cirrhosis and ascites is best treated with cefotaxime injection. The next BEST alternative drug which can be given orally for its treatment is:
Correct Answer: Ofloxacin
Description: SBP is diagnosed when the ascitic fluid is positive for bacterial culture and an elevated ascitic fluid absolute PMN count > 250 cells/mm 3 without an evident surgically treatable source of infection. Empiric antibiotic should be staed even if the culture repo is not available of it is negative because in SBP > 50% cases the culture will be negative. MUST KNOW: Empiric antibiotic treatment of choice in the setting of SBP is inj.Cefotaxime 2g i/v Q 8 hourly. The oral drug which has found as effective as cefotaxime is OFLOXACIN 400 BD x 8 days. It can be given in patients without vomiting, shock, grade II hepatic encephalopathy or serum creatinine > 3 mg/dl. Ref: AASLD practice guidelines: Hepatology, Vol.49, No.6, 2009.
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