Norfloxacin versus alternative antibiotics for prophylaxis of spontaneous bacteria peritonitis in cirrhosis: a systematic review and meta-analysis

BMC Infectious Diseases

Research

Shuailing Song¹  Xiao Li¹  Chunhui Wang¹  Chong Geng²  Yi Yang³  Zeya Tang⁴ 

[1] Department of Gastroenterology, West China Hospital of Sichuan University, NO.37 GuoXue Street, 610041, Chengdu, Sichuan, China;Department of Gastroenterology, West China Hospital of Sichuan University, NO.37 GuoXue Street, 610041, Chengdu, Sichuan, China;Laboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China;Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China;Department of Outpatient, West China Hospital of Sichuan University, Chengdu, Sichuan, China;

关键词: Spontaneous bacterial peritonitis;    Norfloxacin;    Rifaximin;    Primary prophylaxis;    Second prophylaxis;   

DOI  :  10.1186/s12879-023-08557-6

 received in 2023-06-14, accepted in 2023-08-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSpontaneous bacterial peritonitis (SBP) is a life-threatening complication in patients with advanced cirrhosis. Prophylactic Norfloxacin used to be considered effective in SBP prevention, but in recent years its efficacy has been partially compromised by increasing quinolone-resistant bacteria. However, whether the effects of alternative prophylactic regimens are superior to norfloxacin remains controversial. The goal of this study is to compare the effects of norfloxacin with other antibiotics in SBP prophylaxis for cirrhotic patients.MethodsWe systematically searched Pubmed, Embase, and Cochrane Library Databases. Two reviewers independently identified relevant random control trials (RCTs) comparing the role of norfloxacin and other antibiotics in SBP prevention.ResultsEight studies comprising 1043 cirrhotic patients were included in this study. Norfloxacin and alternative antibiotics displayed comparable effects in SBP prophylaxis, survival benefit, overall infection prevention, and safety. Subgroup analyses revealed that rifaximin prophylaxis could reduce the recurrence of SBP with fewer adverse events but failed to improve overall survival compared with norfloxacin.ConclusionsOther antibiotics are a reasonable alternative to norfloxacin in the prophylaxis of SBP. Rifaximin prophylaxis could be an alternative choose of antibiotic for SBP prevention because of its better protective effect and safety.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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