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 HOSPITALAbstract
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.
U. S. Arya Lekshmi, Aswathy Jyothy *, S. Athira Mohan, A. Arif Mohammed, M. S. Arya, N. J. Merlin and Shaiju S. Dharan
Ezhuthachan College of Pharmaceutical Sciences, Thiruvananthapuram, Kerala, India.
05 July 2022
14 October 2022
19 November 2022
01 March 2023