A COMPARATIVE RETROSPECTIVE AND PROSPECTIVE ANALYSIS OF EMERGING RESISTANCE IN EMPIRICAL ANTIBIOTIC TREATMENT AMONG LIVER CIRRHOSIS PATIENTS WITH SPONTANEOUS BACTERIAL PERITONITIS: AN INTERVENTIONAL STUDY IN A TERTIARY CARE HOSPITAL

Background: Previous hospitalization, nosocomial infection and specific risk factors like prolonged quinolone use for Spontaneous Bacterial Peritonitis prophylaxis can be related to drug-resistant bacterial infections and high mortality in liver cirrhosis. Aim and Objectives: To study the prescription pattern of antibiotics used in SBP, compare the efficacy and emerging resistance of antibiotics, and classify patients with different types of ascites. Methodology: The study was conducted in liver cirrhosis patients with SBP retrospectively (2 years) and prospectively (6 months) by a convenient sampling technique. The study was carried out in NIMS Medicity, Thiruvananthapuram. Relevant data were collected via pre-approved data collection form and were subjected to SPSS statistics 22 and R software 4.1.1. analysis. Results: In our study, a total of 116 patients in the retrospective and 21 patients in the prospective study were obtained. 26 patients (22.4%) from the retrospective study and 4 patients (19%) among the prospective study had culture-positive ascitic fluid culture. E. coli was the most commonly obtained organism (69.24%). Third-generation cephalosporins showed higher resistance in the study (51.72%). Interpretation And Conclusion: This study’s findings helped to figure out emerging antibiotic resistance in TGCs among Community-Acquired SBP. Strict adherence to the EASL guidelines for a second-time diagnostic paracentesis after 48 hours of empirical antibiotic therapy initiation (intervention of this study) could be continued as a powerful tool in identifying the accurate efficiency and response to the empirical antibiotic therapy used.