Spontaneous Bacterial Peritonitis Clinical Trial
Official title:
A Randomized, Comparative Open Label Study of Imipenem Versus Cefepime in Spontaneous Bacterial Peritonitis and to Evaluate the Risk Factors for Treatment Failure.
1. All consecutive patients with Cirrhosis and ascites admitted to ILBS (Institute of
Liver & Biliary Sciences) will be evaluated for the presence of SBP (Spontaneous
Bacterial Peritonitis) by ascitic fluid examination at admission.
2. SBP (Spontaneous Bacterial Peritonitis) will be diagnosed in the presence of absolute
neutrophil count (ANC >250/mm3) with/without positive ascitic fluid culture and
Patients with SBP (Spontaneous Bacterial Peritonitis) included in the study will be
randomized to receive cefepime or imipenem.
3. However, other SBP (Spontaneous Bacterial Peritonitis) patients not included for
randomization will be given empirical therapy with 3rd generation cephalosporin
(ceftriaxone).
Baseline evaluation:
Baseline clinical, laboratory and disease severity parameters will be evaluated for each
study patient.
1. Etiology of cirrhosis.
2. Severity of liver disease. CTP (Child-Turcotte-Pugh) score MELD (Model for End-stage
Liver Disease) score MELD (Model for End-stage Liver Disease)-Na score IMSAA score
3. Decompensations/complications of CLD (Chronic Liver Disease) UGI bleed, Hepatic
encephalopathy, AKI (Acute Kidney Injury) etc.
4. Laboratory investigations:
Serum electrolytes Liver function tests Kidney function tests Pro calcitonin USG/CT abdomen
Complete blood counts Coagulation parameters Ascitic fluid analysis- TLC, DLC, Protein,
sugar, culture, SAAG. Chest X ray PA view HBsAg and Anti-HCV and other etiological workup as
available.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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