🫄 Spontaneous Bacterial Peritonitis (SBP) Diagnosis & Treatment
This tool diagnoses and treats spontaneous bacterial peritonitis using ascitic-fluid PMN, acquisition setting, and prior history, with empiric antibiotics, albumin, and prophylaxis.
Spontaneous Bacterial Peritonitis (SBP) Diagnosis & Treatment
Ascitic-fluid neutrophils (PMN)
Acquisition setting
Prior SBP history
When to use
Use to confirm SBP at PMN ≥ 250/mm³, choose empiric antibiotics by setting, add albumin to reduce hepatorenal syndrome, and decide secondary prophylaxis.
How it works
PMN ≥ 250/mm³ → SBP. Community → cefotaxime/ceftriaxone; nosocomial/high-resistance → broad-spectrum per local resistance. Albumin 1.5 g/kg day 1 + 1 g/kg day 3. Prior history → long-term quinolone prophylaxis.
Key points
- Albumin alongside antibiotics is most beneficial when creatinine > 1 mg/dL, BUN > 30, or bilirubin > 4, where it reduces hepatorenal syndrome and death. (original synthesis · not guideline verbatim)
- A 48 h ascitic-PMN recheck assesses response; an insufficient drop prompts adjustment or exclusion of secondary peritonitis.
- Non-selective β-blockers are stopped in hypotensive or refractory SBP.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.