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©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2014; 20(39): 14079-14086
Published online Oct 21, 2014. doi: 10.3748/wjg.v20.i39.14079
Published online Oct 21, 2014. doi: 10.3748/wjg.v20.i39.14079
Multi-resistant bacteria in spontaneous bacterial peritonitis: A new step in management?
Angelo Alves de Mattos, Ane Micheli Costabeber, Livia Caprara Lionço, Cristiane Valle Tovo, Department of Gastroenterology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90430-080, Brasil
Author contributions: Mattos AA conceptualized and designed this editorial; Lionço LC and Costabeber AM reviewed the literature and wrote the manuscript; Mattos AA and Tovo CV reviewed the manuscript critically for important intellectual content; all authors approved the final version of the manuscript.
Correspondence to: Cristiane Valle Tovo, MD, PhD, Department of Gastroenterology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Cel Aurélio Bitencourt 115, Apt. 201, Porto Alegre 90430-080, Brasil. cris.tovo@terra.com.br
Telephone: +55-51-32148158 Fax: +55-51-32148158
Received: March 25, 2014
Revised: May 4, 2014
Accepted: June 26, 2014
Published online: October 21, 2014
Processing time: 209 Days and 9.5 Hours
Revised: May 4, 2014
Accepted: June 26, 2014
Published online: October 21, 2014
Processing time: 209 Days and 9.5 Hours
Core Tip
Core tip: Spontaneous bacterial peritonitis (SBP) is the most typical infection observed in cirrhosis patients. The increasing trend of bacterial resistance development in cirrhotic patients with SBP has been associated with a low treatment efficacy of traditional therapy in nosocomial infections. The use of a broad empirical spectrum antibiotic has been suggested as an alternative. Cephalosporin use should be restricted to community-acquired infections, while changes are necessary with regard to empiric therapy recommendations. Broad-spectrum antimicrobial agents, such as carbapenems with or without glycopeptides or piperacillin-tazobactam, should be considered for the initial treatment of nosocomial infections.