From the Guidelines
Ceftriaxone Dose for Suspected Spontaneous Bacterial Peritonitis (SBP)
The recommended dose of Ceftriaxone for suspected SBP is 1 g every 12-24 hours administered intravenously 1.
- This dose is effective due to the high concentration of the drug delivered to the ascites, resulting in a high resolution rate of 73-100% 1.
- The standard treatment duration is 5 to 10 days, but it should be adjusted according to the patient's symptoms and/or results of antimicrobial susceptibility testing 1.
- It is essential to note that third-generation cephalosporin antibiotics, such as Ceftriaxone, are recommended as they are effective against most causative bacterial pathogens, including Escherichia coli, Klebsiella pneumoniae, and Streptococcus 1.
- The treatment should be started empirically before culture and antibiotic susceptibility test results are available, and antibiotics should be replaced according to the susceptibility results of bacteria cultured from ascites or blood 1.
From the Research
Ceftriaxone Dose for Suspected Spontaneous Bacterial Peritonitis (SBP)
- The recommended dose of ceftriaxone for suspected SBP is 2g daily, as used in clinical trials 2.
- A study published in 1998 used ceftriaxone 2g intravenously once daily for 5 days to treat SBP, with a cure rate of 95% after 5 days of treatment 3.
- Another study published in 2002 used ceftriaxone 1.0g IV every 12 hours for 5 days, with a resolution rate of 73% on day 5 of treatment and 94% after prolonged therapy 4.
- The choice of ceftriaxone dose may depend on the specific patient population and the presence of complicating factors, such as renal impairment or positive culture 4.
- It is also important to note that ceftriaxone should be used in combination with other treatments, such as albumin infusion, to reduce the risk of renal impairment and mortality 5, 6.
Key Considerations
- The diagnosis of SBP should be made using paracentesis and ascitic fluid analysis, with an absolute neutrophil count (ANC) ≥ 250 cells/mm3 being diagnostic of SBP 5.
- The treatment of SBP should be tailored to the individual patient, taking into account the severity of the infection, the presence of complicating factors, and the results of ascitic fluid cultures 6.
- The use of ceftriaxone for SBP has been shown to be effective in reducing morbidity and mortality, but efforts to prevent the development and recurrence of SBP through antibiotic prophylaxis are also important 6.