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Prophylactic Antibiotic Regimen of Such and Runyon for a Patient with Cirrhosis and Ascites

Purpose: To evaluate a patient with cirrhosis and ascites for antibiotic prophylaxis to prevent spontaneous bacterial peritonitis as recommended by Such and Runyon.

Description

A patient with cirrhosis and ascites is at risk for spontaneous bacterial peritonitis when certain clinical conditions are present. Such and Runyon recommended prophylactic antibiotic therapy when the patient is at increased risk. The authors are from Loma Linda University and Hospital General Universitario in Alicante, Spain.


Standard dose used: norfloxacin 400 mg qd po or per nasogastric tube

 

Clinical Situation

Number of Standard Doses

Duration of Administration

gastrointestinal bleeding

2 (bid)

for 7 days

hospitalized patient with ascites fluid protein < 1 gram/dL

1 (qd)

for hospital stay

history of previous episode of spontaneous bacterial peritonitis

1 (qd)

indefinitely

 

where:

• Prophylaxis for urinary tract infection was not listed, probably because the patient would be treated with antibiotics.

• Fluoroquinolones are contraindicated in children under 16 years. They are also contraindicated in pregnant women, but women with ascites are unlikely to be pregnant.


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Specialty

Objective

ICD-10